Individual provider Active NPI

Brittany Leigh Jackson, FNP-C

  • Family Nurse Practitioner
  • Mount Olive, NC
National Provider Identifier
1740836485
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06190592 Issued in NC
Practice address
325 NC-55 West
Mt Olive, NC 28365
Phone
(919) 658-5900
NPI assigned
Aug 16, 2019
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 F06190592 NC Primary

Addresses

Primary practice location

325 NC-55 West
Mt Olive, NC 28365

Mailing address

108 Pantego PL
Pikeville, NC 27863-8216
Phone (919) 273-5133

Other names 1

  • Brittany Leigh Spence Former name

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
I20191008001568 NC Practitioner - Nurse Practitioner 5294066122 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06190592NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Sep 1, 2019 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Sep 1, 2019 Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients

Locations

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

325 NC Highway 55 W
Mount Olive, NC 28365
Phone (919) 658-5900

Interoperability endpoints

  • Direct secure messaging: bspence@goshenmedical.cloudcraftdirect.com

Organizations & group practices 5

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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1740836485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PANTEGO PL",
            "city": "PIKEVILLE",
            "state": "NC",
            "postal_code": "278638216",
            "telephone_number": "919-273-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NC-55 WEST",
            "city": "MT OLIVE",
            "state": "NC",
            "postal_code": "28365",
            "telephone_number": "919-658-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRITTANY",
        "middle_name": "LEIGH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F06190592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "SPENCE",
            "middle_name": "LEIGH",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Olive, NC

Sources for this page

Verify at the official NPI Registry.