Organization Active NPI

Mideastern Primary Care PLLC

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1407482912
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MIDEASTERN PRIMARY CARE PLLC
Practice address
1330 SE Maynard Rd Ste 104
Cary, NC 27511-3628
Phone
(919) 867-1937
Fax
(919) 551-7510
NPI assigned
Mar 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mrs. Ursula Tomika White, APRN, FNP-C
Title
Chief Executive Officer
Phone
(919) 867-1937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1330 SE Maynard Rd Ste 104
Cary, NC 27511-3628

Mailing address

150 Preston Executive Dr Ste 201
Cary, NC 27513-8485
Phone (919) 867-1937

Other names 1

  • Mideastern Telemedicine Doing business as

National Provider Directory

National Provider Directory

Locations

205 S Academy St
Unit 4652
Cary, NC 27519

4804 Page Creek Ln
Ste 115
Durham, NC 27703

1744 Heritage Center Dr
Ste 101
Wake Forest, NC 27587
Phone (919) 867-4996

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1407482912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PRESTON EXECUTIVE DR STE 201",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138485",
            "telephone_number": "919-867-1937",
            "fax_number": "919-551-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SE MAYNARD RD STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113628",
            "telephone_number": "919-867-1937",
            "fax_number": "919-551-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDEASTERN PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "TOMIKA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-867-1937",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mideastern Telemedicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mideastern Telemedicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.