Active NPI
Island Medical Center
- Nurse Practitioner
- Manteo, NC
National Provider Identifier
1821135773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 168637
- Legal business name
- ISLAND MEDICAL CENTER
- Practice address
- 715 US Highway 64
Manteo, NC 27954-9241 - Phone
- (252) 473-2500
- Fax
- (252) 473-1222
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janet Cooke Jarrett
- Title
- Executive Director
- Phone
- (252) 255-6005
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9401185 | NC | |
| Nurse Practitioner | 363L00000X | 168637 | NC | Primary |
Addresses
Primary practice location
715 US Highway 64
Manteo, NC 27954-9241
Mailing address
PO Box 2360
Manteo, NC 27954-2360
Phone (252) 473-2500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890714L | Medicaid | NC | |
| 0174L | Other | NC | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Manteo, NC
- NPI 1285776260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1821135773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2360",
"city": "MANTEO",
"state": "NC",
"postal_code": "279542360",
"telephone_number": "252-473-2500",
"fax_number": "252-473-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 US HIGHWAY 64",
"city": "MANTEO",
"state": "NC",
"postal_code": "279549241",
"telephone_number": "252-473-2500",
"fax_number": "252-473-1222"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ISLAND MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-31",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "JARRETT",
"authorized_official_first_name": "JANET",
"authorized_official_middle_name": "COOKE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "252-255-6005"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NC",
"license": "9401185",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "168637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890714L",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0174L",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manteo, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.