Individual provider Active NPI

Marissa Simone Bunn

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1265314314
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15543 Issued in NC
Practice address
1313 Carolina St Ste 101
Greensboro, NC 27401-6002
Phone
(336) 235-4372
Fax
(336) 235-4381
NPI assigned
Jul 21, 2025
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15543 NC Primary
Rheumatology Physician 207RR0500X 0010-15543 NC

Addresses

Primary practice location

1313 Carolina St Ste 101
Greensboro, NC 27401-6002

Mailing address

1313 Carolina St Ste 101
Greensboro, NC 27401-6002
Phone (336) 235-4372

Other names 1

  • Marissa Simone Petri Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpetri768378@direct.conehealth.com Direct

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
I20251023001642 NC Practitioner - Physician Assistant 2567950371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15543NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Nov 1, 2025 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1313 Carolina St
Ste 100
Greensboro, NC 27401
Phone (336) 370-4070

1313 Carolina St
Ste 101
Greensboro, NC 27401
Phone (336) 235-4372

1313 Carolina St
Ste 102
Greensboro, NC 27401
Phone (336) 832-8014

301 E Wendover Ave
Ste 111
Greensboro, NC 27401
Phone (336) 273-1000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

Interoperability endpoints

  • Direct secure messaging: mpetri768378@direct.conehealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1265314314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 CAROLINA ST STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016002",
            "telephone_number": "336-235-4372",
            "fax_number": "336-235-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 CAROLINA ST STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016002",
            "telephone_number": "336-235-4372",
            "fax_number": "336-235-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "MARISSA",
        "middle_name": "SIMONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15543",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "0010-15543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpetri768378@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1313 Carolina St Ste 101",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274016002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "PETRI",
            "middle_name": "SIMONE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.