Individual provider Active NPI

Haley Grace Gandsey, PNP

  • Pediatric Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1295413458
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5018340 Issued in NC
Practice address
200 Swinburne St
Raleigh, NC 27610
Phone
(919) 250-1120
Fax
(919) 743-7384
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5018340 NC Primary

Addresses

Primary practice location

200 Swinburne St
Raleigh, NC 27610

Mailing address

PO Box 14169
Raleigh, NC 27620-4169
Phone (510) 326-3543

Other practice location 1

10 Sunnybrook Rd
Raleigh, NC 27610-1808
Phone (919) 250-4570

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
I20240502001392 NC Practitioner - Nurse Practitioner 0143660530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018340NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Wake CurrentSince Mar 1, 2024 Accepting new patients
County of Wake Current Accepting new patients
County of Wake CurrentSince Mar 1, 2024 Accepting new patients
Nourish Adolescent Wellness CurrentSince Jul 9, 2023 Accepting new patients

Locations

307 S Salem St
Ste 100
Apex, NC 27502
Phone (919) 215-7455

200 Swinburne St
Raleigh, NC 27610
Phone (919) 250-1120

10 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 250-4570

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1295413458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14169",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276204169",
            "telephone_number": "510-326-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SWINBURNE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "919-250-1120",
            "fax_number": "919-743-7384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Sunnybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101808",
            "country_code": "US",
            "telephone_number": "919-250-4570",
            "fax_number": "919-743-7384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDSEY",
        "first_name": "HALEY",
        "middle_name": "GRACE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5018340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.