Individual provider Active NPI

Vanessa S Cain, FNP

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1780603522
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201753 Issued in NC
Practice address
929 N Front St
Wilmington, NC 28401-3331
Phone
(910) 558-7399
Fax
(919) 654-9306
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 201753 NC Primary
Registered Nurse 163W00000X 97858 NC

Addresses

Primary practice location

929 N Front St
Wilmington, NC 28401-3331

Mailing address

8425 Fazio Dr
Wilmington, NC 28411-7692
Phone (910) 558-7399

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
I20110909002864 NC Practitioner - Nurse Practitioner 8628248218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Healthcare Group LLCGroup PAC ID 4587574355, 9 clinicians

Practice addresses (Care Compare)

420 Eastwood Rd
Suite 102
Wilmington, NC 28403-1866
Phone (910) 362-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
97858NCMDRegistered Nurse
201753NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Healthcare Group LLC CurrentSince Jun 19, 2011 Accepting new patients
Liberty Healthcare Group, LLC CurrentSince Jun 19, 2011 Accepting new patients

Locations

2334 41st St
Wilmington, NC 28403
Phone (910) 815-3122

420 Eastwood Rd
Ste 102
Wilmington, NC 28403
Phone (910) 251-8111

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780603522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 FAZIO DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284117692",
            "telephone_number": "910-558-7399",
            "fax_number": "919-654-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N FRONT ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013331",
            "telephone_number": "910-558-7399",
            "fax_number": "919-654-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "VANESSA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "201753",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "97858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.