Avery Wellness PLLC
Organization Active NPI Family Nurse Practitioner · Newland, NC
NPI 1831928803 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1831928803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- AVERY WELLNESS PLLC
- Practice address
- 137 Notalee St
Newland, NC 28657-9573 - Phone
- (828) 397-9334
- Fax
- (828) 373-9218
- NPI assigned
- Jul 29, 2024
- Organization subpart
- No
Authorized official
- Name
- Jessica Storer, DNP, FNP-C, PMHNP-BC
- Title
- Owner
- Phone
- (828) 397-9334
Practitioners 8
-
Jennie Goodwin, NP
-
Jessica Liniece Storer, FNP-C, PMHNP-BC
-
Robert Dale Clark, M.D.
-
Rosa Marie Benfield, FNP
-
Daniel James Frayne, M.D.
-
Nancy McIntosh Griffith, RN MSN FNP CNM
-
John David Riser, PA-C
-
Donna Smith Tate, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2308695 | Avery Wellness PLLC | Certificate of waiver | Jul 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241028000640 | NC | Part B Supplier - Clinic/Group Practice | 2264965490 |
Receives reassigned benefits from 2 practitioners Practice locations: Newland, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
137 Notalee St
Newland, NC 28657-9573
Mailing address
PO Box 2
Newland, NC 28657-0002
Other names
- AVERY WELLNESS
Other providers in Newland, NC
- Avery Association for Exceptional Citizens
- Avery Association for Exceptional Citizens, Inc.
- Avery County Department of Social Services
- Avery County Schools
- Avery Eye Care Center
- Kendra Jo Back
- Lynn Worley Bailey
- Terylee Banwart
- Emily Maye Beck
- Rosa Marie Benfield
All providers in Newland, NC · Family 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 Aug 27, 2024. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.