Individual provider Active NPI

Eboni Farmer, FNP

  • Family Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1891447314
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015663 Issued in NC
Practice address
104 Pomona Dr
Greensboro, NC 27407-1616
Phone
(336) 268-4100
Fax
(336) 268-3158
NPI assigned
Jan 25, 2022
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015663 NC
Family Nurse Practitioner 363LF0000X 5015663 NC Primary

Addresses

Primary practice location

104 Pomona Dr
Greensboro, NC 27407-1616

Mailing address

625 Mizpah Church Rd
Reidsville, NC 27320-1518
Phone (336) 432-9186

Other practice location 1

217 Turner Dr Ste F
Reidsville, NC 27320-5754
Phone (336) 342-6060

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Eboni.Farmer@eaglep.eclinicaldirectplus.com

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
I20221116003374 NC Practitioner - Nurse Practitioner 1658749924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

104 Pomona Dr
Greensboro, NC 27407-1616
Phone (336) 268-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015663NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA Family Current Accepting new patients
Zack Hall, MD PLLC CurrentSince Aug 4, 2022 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Jan 3, 2025 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Jan 3, 2025 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

104 Pomona Dr
Greensboro, NC 27407
Phone (336) 268-4100

217 Turner Dr
Ste F
Reidsville, NC 27320
Phone (336) 342-6060

Interoperability endpoints

  • Direct secure messaging: eboni.farmer@eaglep.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/25214/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1891447314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MIZPAH CHURCH RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273201518",
            "telephone_number": "336-432-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 POMONA DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071616",
            "telephone_number": "336-268-4100",
            "fax_number": "336-268-3158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Turner Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "NC",
            "postal_code": "273205754",
            "country_code": "US",
            "telephone_number": "336-342-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "EBONI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015663",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Eboni.Farmer@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "104 Pomona Dr",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274071616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.