NPIMap

Individual provider Active NPI

Bonney Lee Wheelden, ARNP

  • Primary Care Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1720267925
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5013199 Issued in NC
Practice address
Southern Regional Area Health Education Center
1601 Owen Drive
Fayetteville, NC 28304
Phone
(910) 678-7251
NPI assigned
Oct 24, 2007
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9281059 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5013199 NC
Primary Care Nurse Practitioner 363LP2300X 5013199 NC Primary

Addresses

Primary practice location

Southern Regional Area Health Education Center
1601 Owen Drive
Fayetteville, NC 28304

Mailing address

5770 Waters Edge Dr
Fayetteville, NC 28314-1055
Phone (850) 758-0111

Other practice location 1

5770 Waters Edge Dr
Fayetteville, NC 28314-1055
Phone (850) 758-0111

Other identifiers 1

IdentifierTypeStateIssuer
3120309 00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310002974 NC Practitioner - Nurse Practitioner 0143465674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fayetteville Area Health Education Foundation IncGroup PAC ID 9830188770, 28 clinicians
Robert C Pennebaker PLLCGroup PAC ID 3870802010, 11 clinicians

Practice addresses (Care Compare)

1601 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 678-0100

2931 Breezewood Ave
Suite 104
Fayetteville, NC 28303-5281
Phone (910) 491-1134

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9281059FLMDFamily Nurse Practitioner
5013199NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert C. Pennebaker PLLC Psychiatric/Mental Health CurrentSince Mar 1, 2025 Accepting new patients
Fayetteville Area Health Education Foundation Inc CurrentSince Dec 13, 2021 Accepting new patients

Locations

1601 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-1152

2931 Breezewood Ave
Ste 104
Fayetteville, NC 28303
Phone (910) 491-1134

Interoperability endpoints

  • Direct secure messaging: bonney.wheelden.1@23362.direct.athenahealth.com

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1720267925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 WATERS EDGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141055",
            "telephone_number": "850-758-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHERN REGIONAL AREA HEALTH EDUCATION CENTER",
            "address_2": "1601 OWEN DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-678-7251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5770 Waters Edge Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283141055",
            "country_code": "US",
            "telephone_number": "850-758-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELDEN",
        "first_name": "BONNEY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9281059",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5013199",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5013199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3120309 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.