Individual provider Active NPI

Meredith Rappaport, PA-C, LCSW

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1205160801
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5287 Issued in TN
Practice address
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone
(919) 319-7202
Fax
(919) 391-7203
NPI assigned
Sep 29, 2009
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-12177 NC
Physician Assistant 363A00000X 5287 TN Primary
Medical Physician Assistant 363AM0700X 0010-12177 NC
Clinical Social Worker 1041C0700X LSW5010 TN

Addresses

Primary practice location

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102

Mailing address

PO Box 114
Kingfield, ME 04947-0114
Phone (865) 297-2497

Other names 1

  • Meredith Rappaport Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220815003549 NC Practitioner - Physician Assistant 0042484222 Reassigns benefits to 2 organizations
I20240109000479 TN Practitioner - Physician Assistant 0042484222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Animo Sano Psychiatry PLLCGroup PAC ID 8729489182, 53 clinicians

Practice addresses (Care Compare)

5501 Fortunes Ridge Dr
Suite P
Durham, NC 27713-6102
Phone (919) 391-7202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW5010TNMDClinical Social Worker
5287TNMDSpeech-Language Pathologist
5010TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems Current Accepting new patients
Resurrection Health Current Accepting new patients

Locations

2574 Frayser Blvd
Memphis, TN 38127
Phone (901) 271-9500

10731 Chapman Hwy
Seymour, TN 37865
Phone (865) 573-0698

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1205160801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "KINGFIELD",
            "state": "ME",
            "postal_code": "049470114",
            "telephone_number": "865-297-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-319-7202",
            "fax_number": "919-391-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "MEREDITH",
        "credential": "PA-C, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12177",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5287",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-12177",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW5010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "RAPPAPORT",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.