Individual provider Active NPI

Evodie Versulien, MD

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1376004465
Registry record updated Sep 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-02985 Issued in NC
Practice address
10208 Cerny St
Raleigh, NC 27617-7884
Phone
(919) 883-4389
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-02985 NC Primary

Addresses

Primary practice location

10208 Cerny St
Raleigh, NC 27617-7884

Mailing address

10208 Cerny St
Raleigh, NC 27617-7884
Phone (919) 883-4389

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220801002511 NC Practitioner - Family Practice 7113254434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke University Affiliated Physicians, Inc.Group PAC ID 3779489588, 452 clinicians

Practice addresses (Care Compare)

10208 Cerny St
Suite 210
Raleigh, NC 27617-7885
Phone (919) 283-4901

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physiciains, Inc. Family Medicine CurrentSince Aug 8, 2022 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Aug 8, 2022 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Past Accepting new patients

Locations

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

10441 Moncreiffe Rd
#101
Raleigh, NC 27617
Phone (800) 266-3853

10208 Cerny St
Raleigh, NC 27617
Phone (919) 234-4468

10208 Cerny St
Ste 210
Raleigh, NC 27617
Phone (919) 457-0340

Interoperability endpoints

  • Direct secure messaging: eversulien524127@direct.medicine.duke.edu

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.

Hospital & facility affiliations 8

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662768000000",
    "number": "1376004465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 CERNY ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177884",
            "telephone_number": "919-883-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 CERNY ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177884",
            "telephone_number": "919-883-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERSULIEN",
        "first_name": "EVODIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-09-10",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-02985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.