NPIMap

Organization Active NPI

Medpsych Integrated PLLC

  • Psychiatry Physician
  • Raleigh, NC
National Provider Identifier
1154898013
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MEDPSYCH INTEGRATED PLLC
Practice address
7780 Brier Creek Pkwy Ste 306
Raleigh, NC 27617
Phone
(850) 292-6579
NPI assigned
Oct 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Juanita Henne
Title
Practice Manager
Phone
(850) 292-6579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

7780 Brier Creek Pkwy Ste 306
Raleigh, NC 27617

Mailing address

7780 Brier Creek Pkwy Ste 306
Raleigh, NC 27617-7849
Phone (850) 292-6579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190128000134 NC Part B Supplier - Clinic/Group Practice 2062759202 Receives reassigned benefits from 14 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

7780 Brier Creek Pkwy
Ste 306
Raleigh, NC 27617
Phone (919) 532-9419

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1154898013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7780 BRIER CREEK PKWY STE 306",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177849",
            "telephone_number": "850-292-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7780 BRIER CREEK PKWY STE 306",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27617",
            "telephone_number": "850-292-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPSYCH INTEGRATED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "HENNE",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "850-292-6579"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.