Individual provider Active NPI

Shara Heather Brown, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Elizabeth City, NC
National Provider Identifier
1720900061
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
5025069 Issued in NC
Practice address
905 Thunder Rd Ste 130
Elizabeth City, NC 27909-7710
Phone
(252) 384-0600
Fax
(844) 494-0227
NPI assigned
Jul 28, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5025069 NC
Gerontology Nurse Practitioner 363LG0600X 5025069 NC Primary

Addresses

Primary practice location

905 Thunder Rd Ste 130
Elizabeth City, NC 27909-7710

Mailing address

905 Thunder Rd Ste 130
Elizabeth City, NC 27909-7710
Phone (252) 384-0600

Other practice location 1

112 Medical Dr
Elizabeth City, NC 27909-3361
Phone (252) 384-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1720900061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 THUNDER RD STE 130",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097710",
            "telephone_number": "252-384-0600",
            "fax_number": "844-494-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 THUNDER RD STE 130",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097710",
            "telephone_number": "252-384-0600",
            "fax_number": "844-494-0227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279093361",
            "country_code": "US",
            "telephone_number": "252-384-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHARA",
        "middle_name": "HEATHER",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5025069",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5025069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.