Individual provider Active NPI

Alice I Manuel, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Washington, NC
National Provider Identifier
1700305547
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009851 Issued in NC
Practice address
120 W Martin Luther King Jr Dr
Washington, NC 27889-4906
Phone
(252) 940-0602
Fax
(252) 940-0924
NPI assigned
Sep 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009851 NC Primary
Registered Nurse 163W00000X 180368 NC

Addresses

Primary practice location

120 W Martin Luther King Jr Dr
Washington, NC 27889-4906

Mailing address

120 W Martin Luther King Jr Dr
Washington, NC 27889-4906
Phone (252) 940-0602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171026003263 NC Practitioner - Nurse Practitioner 2860768389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5009851NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Community Health Services, Inc. CurrentSince Sep 13, 2017 Accepting new patients
Metropolitan Community Health Services, Inc Current Accepting new patients
Metropolitan Community Health Services, Inc. CurrentSince Sep 13, 2017 Accepting new patients

Locations

120 W Martin Luther King Jr Dr
Washington, NC 27889
Phone (252) 940-0602

120 W Martin Luther King Jr Dr
#J
Washington, NC 27889
Phone (252) 940-0602

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700305547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MARTIN LUTHER KING JR DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894906",
            "telephone_number": "252-940-0602",
            "fax_number": "252-940-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MARTIN LUTHER KING JR DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894906",
            "telephone_number": "252-940-0602",
            "fax_number": "252-940-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "ALICE",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009851",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "180368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.