Individual provider Active NPI

Cara Peterson Medlin, BSN, RN, CCRN

  • Critical Care Medicine Registered Nurse
  • Raleigh, NC
National Provider Identifier
1316720139
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
333554 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 333554 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

3711 Exchange Glenwood PL Unit 170
Raleigh, NC 27612-4882
Phone (919) 306-1186

Other identifiers 1

IdentifierTypeStateIssuer
U8387348704OtherNCCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
333554NCMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1316720139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 EXCHANGE GLENWOOD PL UNIT 170",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124882",
            "telephone_number": "919-306-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "CARA",
        "middle_name": "PETERSON",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NC",
            "license": "333554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "U8387348704",
            "state": "NC"
        }
    ],
    "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 Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.