HOMETOWN MED OF MOYOCK AND OBX PLLC
NPI 1750021325
Nurse Practitioner - Primary Care in Moyock, NC

NPI Status: Active since March 31, 2022

Contact Information

109 CURRITUCK COMMERICAL DR STE A
MOYOCK, NC
ZIP 27958
Phone: (252) 772-1110
Fax: (252) 319-3678

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  • Organization
  • Nurse Practitioner
  • Primary Care
  • CLIA Number: 34D2263381
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-27-2026

About HOMETOWN MED OF MOYOCK AND OBX PLLC

This page provides the complete NPI Profile along with additional information for Hometown Med Of Moyock And Obx Pllc, a provider established in Moyock, North Carolina operating as a Nurse Practitioner, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1750021325 assigned on March 2022. The practitioner's primary taxonomy code is 363LP2300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Hometown Med Of Moyock And Obx Pllc. The authorized official of this NPI record is Carmen M Wynes Np (Owner)

NPI
1750021325
Provider Legal Name
HOMETOWN MED OF MOYOCK AND OBX PLLC
Other Organization Name
HOMETOWN MED OF MOYOCK AND OBX PLLC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
109 CURRITUCK COMMERICAL DR STE A MOYOCK, NC 27958
Location Phone
(252) 772-1110
Location Fax
(252) 319-3678
Mailing Address
109 CURRITUCK COMMERICAL DR STE A MOYOCK, NC 27958
Mailing Phone
(252) 772-1110
Mailing Fax
(252) 319-3678
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-31-2022
Last Update Date
04-26-2023
Code Navigator

A nurse practitioner (NP) like Hometown Med Of Moyock And Obx Pllc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Primary Care

Taxonomy Code
363LP2300X
Type
Physician Assistants & Advanced Practice Nursing Providers

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
22083A0300XAllopathic & Osteopathic Physicians

Preventive Medicine
Addiction Medicine

 
3261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CARMEN M WYNES NP

Authorized Official Title
OWNER
Authorized Official Phone
(252) 772-1110

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1073000816MEDICAID (05)VA 
1750021325MEDICAID (05)NC 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2263381
Facility Type
Physician Office
Certificate Effective Date
June 28, 2024
Certificate Expiration Date
June 27, 2026
Laboratory Director
CARMEN M. WYNES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Hometown Med Of Moyock And Obx Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1750021325, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
1
Doubled → 2
Pos 8
3
Unchanged
Pos 9
2
Doubled → 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 0 → 0 1 → 2 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 0 + 0 + 0 + 2 + 2 + 3 + 4 + 24 = 45

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1750021325.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750021325, enumerated as an "organization" on March 31, 2022.

The provider is located at 109 CURRITUCK COMMERICAL DR STE A MOYOCK, NC 27958 and the phone number is (252) 772-1110.

Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.