Individual provider Active NPI

Anita Black Woolard, FNP

  • Family Nurse Practitioner
  • Washington, NC
National Provider Identifier
1811193980
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0050-03121 Issued in NC
Practice address
501 W 15TH St
Washington, NC 27889-3565
Phone
(252) 975-2667
Fax
(252) 975-2507
NPI assigned
Jun 25, 2007
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 0050-03121 NC Primary

Addresses

Primary practice location

501 W 15TH St
Washington, NC 27889-3565

Mailing address

501 W 15TH St
Washington, NC 27889-3565
Phone (252) 975-2667

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awoolard20555@direct.vidanthealth.com

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
I20071110000141 NC Practitioner - Nurse Practitioner 2860580792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Brody School of Medicine at East Carolina University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

501 W 15TH St
Washington, NC 27889-3565
Phone (252) 975-2667

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0050-03121NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Aug 1, 2011 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

501 W 15th St
Washington, NC 27889
Phone (252) 975-2667

608 E 12th St
Washington, NC 27889
Phone (252) 758-3211

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

Interoperability endpoints

  • Direct secure messaging: awoolard20555@direct.ecuhealth.com

Organizations & group practices 1

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1811193980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893565",
            "telephone_number": "252-975-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893565",
            "telephone_number": "252-975-2667",
            "fax_number": "252-975-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLARD",
        "first_name": "ANITA",
        "middle_name": "BLACK",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "0050-03121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awoolard20555@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.