JENNIFER S. BERETSKY NP-C NPI 1164800215

NPI Information

  • NPI: 1164800215
  • Provider Name: JENNIFER S. BERETSKY, NP-C
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2555 COURT DR STE 450
    GASTONIA, NC
    ZIP 28054
  • Phone: (704) 671-7652

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NPI Details

Jennifer S. Beretsky, NP-C is an adult health nurse practitioner in Gastonia, NC with 12 years of experience. Jennifer S. Beretsky, NP-C NPI is 1164800215. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

2555 COURT DR STE 450
GASTONIA, NC
ZIP 28054
Phone: (704) 671-7652
Fax: (704) 671-7656

The NPI 1164800215 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/9/2015 and was last updated on 10/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner5007938NORTH CAROLINANo
2363L00000XNurse PractitionerR205065MARYLANDNo
3363LA2200XNurse PractitionerAdult Health237317NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10397730007OTHERNORTH CAROLINANSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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