Individual provider Active NPI

Anna Sue Bidegain, RN

  • Pediatric Registered Nurse
  • Charlotte, NC
National Provider Identifier
1083581003
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
342500 Issued in NC
Practice address
3129 Springbank LN Ste 100
Charlotte, NC 28226-3379
Phone
(704) 384-5151
NPI assigned
Oct 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 342500 NC Primary

Addresses

Primary practice location

3129 Springbank LN Ste 100
Charlotte, NC 28226-3379

Mailing address

3403 Timber Mill Dr
Stallings, NC 28104-1156
Phone (704) 512-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
342500NCMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1083581003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 TIMBER MILL DR",
            "city": "STALLINGS",
            "state": "NC",
            "postal_code": "281041156",
            "telephone_number": "704-512-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 SPRINGBANK LN STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263379",
            "telephone_number": "704-384-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDEGAIN",
        "first_name": "ANNA",
        "middle_name": "SUE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NC",
            "license": "342500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.