Individual provider Active NPI

Krista Gruber, FNP

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1851018774
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5018096 Issued in NC
Practice address
1709 S 16TH St Ste a
Wilmington, NC 28401-6491
Phone
(910) 452-8633
NPI assigned
Oct 21, 2022
Last updated
Jun 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5018096 NC Primary

Addresses

Primary practice location

1709 S 16TH St Ste a
Wilmington, NC 28401-6491

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

Other names 1

  • Krista Stone Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL skrista@med.umich.edu Direct

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
I20230713002960 NC Practitioner - Nurse Practitioner 7113387788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarheel Emergency Group, PLLCGroup PAC ID 6709268576, 40 clinicians

Practice addresses (Care Compare)

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018096NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tarheel Emergency Group, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Senior Health Associates, P.a. CurrentSince Jun 12, 2023 Accepting new patients
Carolina Quickcare Family Practice, PLLC CurrentSince Dec 13, 2023 Accepting new patients

Locations

2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

4612 Main St
Shallotte, NC 28470
Phone (910) 444-2970

1709 S 16th St
Ste A
Wilmington, NC 28401
Phone (910) 452-8633

1984 S 16th St
Ste 1
Wilmington, NC 28401
Phone (910) 452-8633

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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 1

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": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1851018774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 16TH ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016491",
            "telephone_number": "910-452-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "KRISTA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5018096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "skrista@med.umich.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "skrista@med.umich.edu",
            "address_1": "1500 E Medical Center Dr",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481095000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "STONE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.