Individual provider Active NPI

Tabitha Hunt Cousart-Hutchens, NURSE PRACTITIONER

  • Nurse Practitioner
  • Yadkinville, NC
National Provider Identifier
1982839197
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004378 Issued in NC
Practice address
305 E Lee Ave
Yadkinville, NC 27055-8132
Phone
(336) 679-2661
Fax
(336) 679-7056
NPI assigned
May 18, 2009
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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 171026 NC
Nurse Practitioner 363L00000X 5004378 NC Primary

Addresses

Primary practice location

305 E Lee Ave
Yadkinville, NC 27055-8132

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

108 S State St
Yadkinville, NC 27055-8249
Phone (336) 679-2733

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
I20090724000260 NC Practitioner - Nurse Practitioner 0941353841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

305 E Lee Ave
Yadkinville, NC 27055-8132
Phone (336) 679-2661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171026NCMDNurse Practitioner
5004378NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 29, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 29, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients
BRMG-PC PastSince Aug 20, 2012 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

250 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 718-1000

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

305 E Lee Ave
Yadkinville, NC 27055
Phone (336) 679-2661

Interoperability endpoints

  • Direct secure messaging: tcousarthutchens1120917@direct.novanthealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1982839197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558132",
            "telephone_number": "336-679-2661",
            "fax_number": "336-679-7056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 S State St",
            "address_purpose": "LOCATION",
            "city": "Yadkinville",
            "state": "NC",
            "postal_code": "270558249",
            "country_code": "US",
            "telephone_number": "336-679-2733",
            "fax_number": "336-679-6263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUSART-HUTCHENS",
        "first_name": "TABITHA",
        "middle_name": "HUNT",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "171026",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yadkinville, NC

Sources for this page

Verify at the official NPI Registry.