Individual provider Active NPI

Jennifer Lynn Stockwell, FNP-BC

  • Family Nurse Practitioner
  • Henderson, NC
National Provider Identifier
1881383636
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
STOC-M3Y3M Issued in NC
Practice address
511 Ruin Creek Rd Ste 101
Henderson, NC 27536-5919
Phone
(252) 436-0440
NPI assigned
May 5, 2023
Last updated
May 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 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 STOC-M3Y3M NC Primary

Addresses

Primary practice location

511 Ruin Creek Rd Ste 101
Henderson, NC 27536-5919

Mailing address

2010 Sunset Rd
Oxford, NC 27565-8498
Phone (336) 583-8173

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
I20230725004171 NC Practitioner - Nurse Practitioner 2365803228 Reassigns benefits to 2 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

Practice addresses (Care Compare)

3762 Durham Rd
Suite B
Roxboro, NC 27573-2741
Phone (336) 322-1024

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
STOC-M3Y3MNCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Person Physician Practices, LLC CurrentSince Jan 1, 2025 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Aug 1, 2023 Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Aug 1, 2023 Accepting new patients
DLP Person Physician Practices LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440

3762 Durham Rd
#B
Roxboro, NC 27573
Phone (336) 322-1024

3762 Durham Rd
Ste A
Roxboro, NC 27573
Phone (336) 330-0400

601 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 5

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 2

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": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1881383636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SUNSET RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275658498",
            "telephone_number": "336-583-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD STE 101",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-436-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "STOC-M3Y3M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.