Individual provider Active NPI

Jessica Rose Stone, PMHNP-BC, PMHCNS-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rocky Mount, NC
National Provider Identifier
1962711697
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5006304 Issued in NC
Practice address
90 Guardian CT
Rocky Mount, NC 27804-3017
Phone
(252) 212-3350
Fax
(919) 882-1875
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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 261257 NC
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 261257 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5006304 NC Primary

Addresses

Primary practice location

90 Guardian CT
Rocky Mount, NC 27804-3017

Mailing address

PO Box 2723
Rocky Mount, NC 27802-2723
Phone (252) 212-6802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20131105001959 NC Practitioner - Nurse Practitioner 1355521501 Reassigns benefits to 2 organizations
I20150714001504 SC Practitioner - Nurse Practitioner 1355521501

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Opportunities Industrialization Center, Inc. CurrentSince Nov 1, 2020 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
Atlantic Psychiatric Services Past Accepting new patients

Locations

204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066

90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350

515 Barbour Rd
Smithfield, NC 27577
Phone (919) 227-6261

510 Thompson St
Gaffney, SC 29340
Phone (864) 489-3101

Organizations & group practices 3

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": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1962711697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-212-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 GUARDIAN CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043017",
            "telephone_number": "252-212-3350",
            "fax_number": "919-882-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "credential": "PMHNP-BC, PMHCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "261257",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "261257",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5006304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.