Individual provider Active NPI

Tabitha Floyd Schilly, FNP-BC

  • Family Nurse Practitioner
  • Henderson, NC
National Provider Identifier
1720657729
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014586 Issued in NC
Practice address
568 Ruin Creek Rd Ste 3
Henderson, NC 27536-5921
Phone
(252) 436-1080
NPI assigned
Jun 23, 2021
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5014586 NC Primary

Addresses

Primary practice location

568 Ruin Creek Rd Ste 3
Henderson, NC 27536-5921

Mailing address

568 Ruin Creek Rd Ste 3
Henderson, NC 27536-5921
Phone (252) 436-1080

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
I20210816000260 NC Practitioner - Nurse Practitioner 1557765435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

568 Ruin Creek Rd
Suite 3
Henderson, NC 27536-5921
Phone (252) 436-1080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5014586NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Sep 20, 2021 Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Sep 20, 2021 Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

568 Ruin Creek Rd
Ste 3
Henderson, NC 27536
Phone (252) 436-1080

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: tabitha.schilly.1@20247.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1720657729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD STE 3",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365921",
            "telephone_number": "252-436-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD STE 3",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365921",
            "telephone_number": "252-436-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLY",
        "first_name": "TABITHA",
        "middle_name": "FLOYD",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.