Individual provider Active NPI

Elaine Lamb Cudnik, APRN

  • Pediatric Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1164629267
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5014032 Issued in NC
Practice address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone
(252) 816-3865
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN001528 NV
Pediatric Nurse Practitioner 363LP0200X 5014032 NC Primary
Pediatric Nurse Practitioner 363LP0200X RN965576 DC

Addresses

Primary practice location

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Mailing address

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 816-3865

Other practice location 1

21 Locust St
Reno, NV 89502-1316
Phone (775) 982-5000

Other identifiers 2

IdentifierTypeStateIssuer
11820188OtherCAQH
1164629267MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ecudnik346418@direct.vidanthealth.com

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
I20240515004512 NC Practitioner - Nurse Practitioner 9830286061 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001528NVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carteret Medical Group LLC CurrentSince Mar 26, 2025 Accepting new patients
East Carolina University Current Accepting new patients
Carteret County General Hospital Corporation CurrentSince Mar 26, 2025 Accepting new patients
East Carolina University CurrentSince May 15, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Jan 26, 2024 Accepting new patients
PM Pediatrics of Delaware PA Past Accepting new patients

Locations

1165 Cedar Point Blvd
Ste H
Cedar Point, NC 28584
Phone (252) 499-6850

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15484/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1164629267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-816-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-816-3865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Locust St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021316",
            "country_code": "US",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUDNIK",
        "first_name": "ELAINE",
        "middle_name": "LAMB",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "APRN001528",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5014032",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN965576",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11820188",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164629267",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ecudnik346418@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.