Individual provider Active NPI

Abigail Rose Squires, FNP-BC

  • Nurse Practitioner
  • Bolivia, NC
National Provider Identifier
1902792815
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
PENDING Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 721-1700
NPI assigned
Jun 16, 2025
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 PENDING NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

7056 White Bridge LN SE
Leland, NC 28451-7798
Phone (910) 620-1184

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
I20250818002191 NC Practitioner - Nurse Practitioner 3274032131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brunswick Physician Partners PLLCGroup PAC ID 2062752470, 7 clinicians

Practice addresses (Care Compare)

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGNCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Physician Partners, PLLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

Interoperability endpoints

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

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, 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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1902792815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7056 WHITE BRIDGE LN SE",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284517798",
            "telephone_number": "910-620-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.