BETH ANN DEKONINCK (NPI# 1285693960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285693960 |
Entity Type | Individual |
Full Name | BETH ANN DEKONINCK |
Credential | NP-C |
Practice Address |
207 E Meadow Rd Ste 6 Eden NC 27288-3469 |
Practice Telephone | 2192041854 |
Mailing Telephone | 2192041854 |
Enumeration Date | 2006-03-21 |
Last Update Date | 2019-11-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
71000315A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 200169950 | 05 | |
IN | ANTHEM PROVIDER NUMBER | 000000372024 | 01 |
IN | PHCS PID NUMBER | 9397614 | 01 |
Street Address |
207 E MEADOW RD STE 6 |
City | EDEN |
State | NC |
Zip Code | 27288-3469 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205486297 | The Caswell Family Medical Center, Inc. | Clinic/Center | 207 E Meadow Rd Ste 6, Eden, NC 27288-3469 | 2019-09-12 |
1033693932 | Jason Christopher Vaughn | Nurse Practitioner | 207 E Meadow Rd Ste 6, Eden, NC 27288-3469 | 2018-09-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639781297 | Bailey Shea Scism | Pharmacist | 103 W Stadium Dr., Eden, NC 27288 | 2020-08-17 |
1538640628 | Donnell Corey Brown Jr. | Technician | 519 Orchard Drive, Eden, NC 27288 | 2018-08-27 |
1851728182 | Linda Mitchell | Physical Therapy Assistant | 114 E Kings Hwy, Eden, NC 27288 | 2013-10-01 |
1033341573 | Central State of The Carolinas, Inc. | Day Training, Developmentally Disabled Services | 229 Cedar St., Eden, NC 27288 | 2009-08-18 |
1114186483 | Enrich Cosmetic Center | Internal Medicine | 406 B Thompson St, Eden, NC 27288 | 2008-06-03 |
1265630891 | John R. Dabbs Jr. Dc PC | Preferred Provider Organization | 405 Boone Road, Eden, NC 27288 | 2007-07-05 |
1235283961 | James Harrison Eggleston | Dentist | 113 West Arbor Lane, Eden, NC 27288 | 2007-01-22 |
1962563940 | Barbara Collins Tanner | Nurse Practitioner | 134 North Pierce Street, Morehead High School Student Health Center, Eden, NC 27288 | 2006-12-13 |
1285690974 | Robert Maurice Vaughn | Chiropractor | 405 Boone Rd, Eden, NC 27288 | 2006-04-22 |
1619930666 | Direct Respiratory Services | Durable Medical Equipment & Medical Supplies | 302a North Pierce Street, Eden, NC 27288 | 2006-04-10 |
Find all providers in zip 27288 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467977884 | Eden Family Care and Medical Aesthetics | Nurse Practitioner | 2612 N Highway 162, Eden, UT 84310-9745 | 2017-08-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295334647 | Kennitrish Nickola Bracey | Nurse Practitioner | 5124 Red Poll Dr, Greensboro, NC 27405-9794 | 2020-10-17 |
1255947974 | Alice Lorraine Fagan | Nurse Practitioner | 2130 Highland View Ln, Charlotte, NC 28214-9425 | 2020-09-17 |
1689286270 | Meylien Delgado Lee | Nurse Practitioner | 510 S Spruce St, Wilkesboro, NC 28697-2846 | 2020-08-17 |
1124638317 | Jakita Strong | Nurse Practitioner | 1506 Ladora Dr, Charlotte, NC 28262-6414 | 2020-08-03 |
1689284820 | Corrie Hansen | Nurse Practitioner | 1700 Tarboro St W Ste 100, Wilson, NC 27893-3481 | 2020-08-03 |
1609490382 | Brooke Martin Shaw | Nurse Practitioner | 5514, 350 N Cox St, Ste 6, Asheboro, NC 27203 | 2020-05-29 |
1467075440 | Lydia A. Teague | Nurse Practitioner | 120 N Medical Drive Unc-ch Son: Carrington Hall Chapel, Chapel Hill, NC 27599-0001 | 2020-05-25 |
1689209710 | Ana Rita Frey | Nurse Practitioner | 601 E 5th St Ste 140, Charlotte, NC 28202-3092 | 2020-03-09 |
1578109427 | Mia Licole Saulter | Nurse Practitioner | 3961 Stafford Run Ct, High Point, NC 27265-9480 | 2019-11-25 |
1801430715 | Erica Nicole Ebohon | Nurse Practitioner | 3803 Arundel Ct, Greensboro, NC 27406-9832 | 2019-11-04 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.