Individual provider Active NPI

Jennifer Dawn Eleey, FNP-BC

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1942833868
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012890 Issued in NC
Practice address
1918 Randolph Rd Ste 400
Charlotte, NC 28207-1196
Phone
(704) 384-9437
Fax
(704) 384-9440
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 269057 NC
Family Nurse Practitioner 363LF0000X 5012890 NC
Nurse Practitioner 363L00000X 5012890 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 400
Charlotte, NC 28207-1196

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

7845 Little Ave
Charlotte, NC 28226-8198
Phone (704) 375-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200408003307 NC Practitioner - Nurse Practitioner 9234568445 Reassigns benefits to 2 organizations
I20250519000175 OH Practitioner - Nurse Practitioner 9234568445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

190 Kimel Park Dr
Suite 120
Winston Salem, NC 27103-6946
Phone (336) 718-7063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5012890NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 11, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Eventus Wholehealth Aco LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Eventus Ecs, Inc Nurse Practitioner CurrentSince Mar 10, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 11, 2025 Accepting new patients
Extended Care Specialists, Inc Nurse Practitioner CurrentSince Mar 10, 2025 Accepting new patients
Extended Care Specialists, Inc Nurse Practitioner PastSince Oct 6, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

4400 Easton Cmns
Ste 125
Columbus, OH 43219
Phone (514) 546-1900

3958 Brown Park Dr
Ste D
Hilliard, OH 43026

Interoperability endpoints

  • Direct secure messaging: jeleey669820@direct.novanthealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1942833868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071196",
            "telephone_number": "704-384-9437",
            "fax_number": "704-384-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7845 Little Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282268198",
            "country_code": "US",
            "telephone_number": "704-375-0100",
            "fax_number": "704-887-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELEEY",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "269057",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012890",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.