Individual provider Active NPI

Cathleen Medellin

  • Family Nurse Practitioner
  • Durham, NC
National Provider Identifier
1154891646
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014339 Issued in NC
Practice address
5306 NC Highway 55 Ste 105
Durham, NC 27713-7812
Phone
(337) 991-9276
NPI assigned
Nov 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP.023787 OH
Family Nurse Practitioner 363LF0000X 5014339 NC Primary

Addresses

Primary practice location

5306 NC Highway 55 Ste 105
Durham, NC 27713-7812

Mailing address

5750 Johnston St Ste 205
Lafayette, LA 70503-5345
Phone (337) 991-9276

Other practice location 1

1585 Georgesville Square Dr
Columbus, OH 43228-3777
Phone (614) 335-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206000205 NC Practitioner - Nurse Practitioner 8729323241 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2800 Kidd Rd
Raleigh, NC 27610-1842
Phone (919) 231-9727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5014339NCMDFamily Nurse Practitioner
CNP.023787OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Eldercare PA CurrentSince Apr 1, 2025 Accepting new patients
Shae Medical, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Curana Health of North Carolina PLLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

3200 Waterfield Dr
Garner, NC 27529
Phone (919) 502-1187

4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114

Interoperability endpoints

  • Direct secure messaging: cathleen.medellin@shaemedical.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1154891646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 JOHNSTON ST STE 205",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035345",
            "telephone_number": "337-991-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55 STE 105",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "337-991-9276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 Georgesville Square Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432283777",
            "country_code": "US",
            "telephone_number": "614-335-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDELLIN",
        "first_name": "CATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP.023787",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.