Individual provider Active NPI

Tina Bean

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1700993698
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5004725 Issued in NC
Practice address
906 S College Rd Unit B
Wilmington, NC 28403-4412
Phone
(910) 508-9885
NPI assigned
Aug 24, 2006
Last updated
Oct 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 5004725 NC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5004725 NC

Addresses

Primary practice location

906 S College Rd Unit B
Wilmington, NC 28403-4412

Mailing address

194 Tomahawk Hwy
Harrells, NC 28444-9765
Phone (910) 532-4106

Other practice location 1

194 Tomahawk Hwy
Harrells, NC 28444-9765
Phone (910) 532-4106

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
I20100628000353 NC Practitioner - Nurse Practitioner 1759342835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

902 S College Rd
Suite 906
Wilmington, NC 28403-4412
Phone (910) 508-9885

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004725NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri County Community Health Council Inc CurrentSince May 17, 2010 Accepting new patients
Flourish Medical and Behavioral Health Group, PLLC Family CurrentSince Jul 7, 2023 Accepting new patients

Locations

3331 Easy St
Dunn, NC 28334

194 Tomahawk Hwy
Harrells, NC 28444
Phone (910) 532-4106

5531 Eleanor Roosevelt Ln
Willard, NC 28478
Phone (910) 285-0400

902 S College Rd
Ste 906
Wilmington, NC 28403
Phone (910) 508-9885

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHCDD/Endpoint/ACHCDD

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1700993698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 TOMAHAWK HWY",
            "city": "HARRELLS",
            "state": "NC",
            "postal_code": "284449765",
            "telephone_number": "910-532-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S COLLEGE RD UNIT B",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034412",
            "telephone_number": "910-508-9885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "194 Tomahawk Hwy",
            "address_purpose": "LOCATION",
            "city": "Harrells",
            "state": "NC",
            "postal_code": "284449765",
            "country_code": "US",
            "telephone_number": "910-532-4106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAN",
        "first_name": "TINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004725",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.