Mrs Shadara King, AGNP-C - Medicare Nurse Practitioner in Raleigh, NC

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Mrs Shadara King, AGNP-C is a medicare enrolled "Nurse Practitioner" in Raleigh, North Carolina. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is 3214 Charles B Root Wynd Ste 203, Raleigh, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 877-6800.

Mrs Shadara King is licensed to practice in North Carolina (license number 5011293) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1093286015.

Contact Information

Mrs Shadara King, AGNP-C
3214 Charles B Root Wynd Ste 203,
Raleigh, NC 27612-5440
(919) 877-6800
(844) 881-7701

Map and Direction




Provider's Profile

Full NameMrs Shadara King
GenderFemale
SpecialityNurse Practitioner
Experience9 Years
Location3214 Charles B Root Wynd Ste 203, Raleigh, North Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Shadara King graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1093286015
  • Provider Enumeration Date: 12/17/2018
  • Last Update Date: 07/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8022355023
  • Enrollment ID: I20240730002420

Medical Identifiers

Medical identifiers for Mrs Shadara King such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093286015NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner LP-0010645 (Delaware)Secondary
363L00000XNurse Practitioner 33592 (Tennessee)Secondary
363L00000XNurse Practitioner 27576 (South Carolina)Secondary
363L00000XNurse Practitioner 3-001270 (Alabama)Secondary
363LA2200XNurse Practitioner - Adult Health 5011293 (North Carolina)Secondary
363LA2200XNurse Practitioner - Adult Health AG03180040 (Georgia)Secondary
363L00000XNurse Practitioner 5011293 (North Carolina)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shadara King allows following entities to bill medicare on her behalf.
Entity NameEclipse Wellness Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245992262
PECOS PAC ID: 7719370154
Enrollment ID: O20240614002570

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shadara King is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Shadara King, AGNP-C
185 Timber Wolf Xing,
Garner, NC 27529-9279

Ph: (302) 228-6434		Mrs Shadara King, AGNP-C
3214 Charles B Root Wynd Ste 203,
Raleigh, NC 27612-5440

Ph: (919) 877-6800

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.