Charmay Deneen Fryar-Robinson
Individual provider Active NPI Adult Health Nurse Practitioner · Eastover, NC
NPI 1831738178 · NPPES record last updated Dec 8, 2021
Key facts
- NPI
- 1831738178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 5012690 (NC)
- Practice address
- 3551 Dunn Rd Ste 101
Eastover, NC 28312-9417 - Phone
- (910) 483-6277
- Fax
- (910) 483-6369
- NPI assigned
- Jan 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210223000555 | NC | Practitioner - Family Practice | 1456766591 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FRYA-E02HVF | NC | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | FRYA-E02HVF | NC | |
| Adult Health Nurse Practitioner | 363LA2200X | 5012690 | NC | Yes |
Addresses
Primary practice location
3551 Dunn Rd Ste 101
Eastover, NC 28312-9417
Mailing address
3947 Dunn Rd
Eastover, NC 28312-8533
Phone (910) 483-6277
Other practice location 1
1402 Wayne Memorial Dr
Goldsboro, NC 27534-2235
Phone (919) 735-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5012690 | Other | NC | STATE LICENSE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Eastover | Health Information Exchange (HIE) |
Other providers in Eastover, NC
- Eastover Drug LLC
- Eastover Drug, LLC
- Eastover Family Care PC
- Emmanuel Medical Transport LLC
- Vickie Lynn Farmer
- Sharon Louise Gallagher
- Anne Porcher Chalmers Goforth
- Harvest Health Services, LLC
- Zachary Clay Hayes
- Anna M Hiltibidal
All providers in Eastover, NC · Adult Health Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.