Individual provider Active NPI

Tikia Yelverton, DNP

  • Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1891279006
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010959 Issued in NC
Practice address
3610 Bush St
Raleigh, NC 27609-7511
Phone
(919) 876-3130
Fax
(919) 876-3134
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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 5010959 NC Primary

Addresses

Primary practice location

3610 Bush St
Raleigh, NC 27609-7511

Mailing address

1502 W NC Highway 54 Ste 103
Durham, NC 27707-5572

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
I20181112002629 NC Practitioner - Nurse Practitioner 0547514432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

3610 Bush St
Raleigh, NC 27609-7511
Phone (919) 876-3130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Care Centers, North Carolina, PLLC CurrentSince Sep 2, 2018 Accepting new patients

Locations

4 Doctors Park
Ste H
Asheville, NC 28801
Phone (828) 633-6070

1502 W NC Highway 54
Ste 103
Durham, NC 27707
Phone (919) 354-0840

3610 Bush St
Raleigh, NC 27609
Phone (919) 876-3130

2261 Nash St NW
Wilson, NC 27896
Phone (252) 237-8403

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1891279006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54 STE 103",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 BUSH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097511",
            "telephone_number": "919-876-3130",
            "fax_number": "919-876-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELVERTON",
        "first_name": "TIKIA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.