Individual provider Active NPI

Karen Ann Chavis, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1881247708
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012070 Issued in NC
Practice address
461 Western Blvd Ste 122
Jacksonville, NC 28546-7637
Phone
(910) 333-0283
Fax
(910) 333-0513
NPI assigned
Jul 19, 2019
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 5012070 NC Primary

Addresses

Primary practice location

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637

Mailing address

PO Box 986513
Department 100
Boston, MA 02298-6513
Phone (910) 219-8326

Other names 1

  • Karen Ann Walters Former name

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
I20200410001775 NC Practitioner - Nurse Practitioner 5799114831 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Star Medical Clinic PLLC Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Dec 15, 2022 Accepting new patients
Amm Healthcare, PA Family Medicine CurrentSince May 22, 2022 Accepting new patients
Goshen Medical Center, Inc CurrentSince Dec 15, 2022 Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Family Care Clinic, P.a. Family Medicine PastSince Jul 12, 2021 Accepting new patients
Meadows Lutcavage Smith Vinton Fidler & Long DDS PA PastSince Jul 1, 2021 Accepting new patients

Locations

1624 White Oak Church Rd
Apex, NC 27523
Phone (910) 486-6818

408 Fairview St
Clinton, NC 28328
Phone (910) 596-2400

906 N US Highway 421
Clinton, NC 28328
Phone (910) 592-1462

801 Tilghman Dr
Ste A
Dunn, NC 28334
Phone (910) 892-6500

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

3613 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 354-1720

461 Western Blvd
Ste 122
Jacksonville, NC 28546
Phone (910) 330-2335

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kchavis@goshenmedical.cloudcraftdirect.com

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1881247708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "KAREN",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "WALTERS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.