NPIMap

Individual provider Active NPI

Mary Payne Mentzer, NP

  • Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1962858258
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008407 Issued in NC
Practice address
557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone
(910) 484-8114
Fax
(910) 484-1564
NPI assigned
May 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5008407 NC
Nurse Practitioner 363L00000X 5008407 NC Primary
Adult Health Nurse Practitioner 363LA2200X 5008407 NC

Addresses

Primary practice location

557 Sandhurst Dr
Fayetteville, NC 28304-4433

Mailing address

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Other practice location 1

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (910) 433-3847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701000541 NC Practitioner - Nurse Practitioner 6800188319 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Kidney Care PAGroup PAC ID 4587576020, 24 clinicians

Practice addresses (Care Compare)

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 15, 2023 Accepting new patients
Physicians Eldercare PA CurrentSince Aug 14, 2024 Accepting new patients
Novant Health Employer Solutions, LLC CurrentSince Oct 5, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 15, 2023 Accepting new patients
Curana Health of North Carolina PLLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

108 Providence Rd
Charlotte, NC 28207
Phone (336) 277-3431

4500 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211
Phone (704) 384-7910

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

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

4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114

Interoperability endpoints

  • Direct secure messaging: mmentzer71541@direct.acumenmd.com
  • Direct secure messaging: mmentzer713883@direct.novanthealth.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1962858258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114",
            "fax_number": "910-484-1564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "910-433-3847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "MARY",
        "middle_name": "PAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5008407",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008407",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5008407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.