Caedora Marylouise Benton, NP, PMHNP, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5012193 Issued in NC

Practice address

2101 Garner Rd
Raleigh, NC 27610-0114

Phone

(919) 787-6131

Fax

(919) 571-2932

NPI assigned

Sep 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Caedora Marylouise Gardner Former name

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southlight HealthcareGroup PAC ID 6901947613, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caedora.benton@direct.slhc.nchie.net

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.

• Maeb PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, NC
  • NPI 1760279228

  Family

  Medicare reassignment NPD Authorized official
• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1316268345
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  Medicare reassignment NPD
• Zion Healing Centers NC LLC

  • Clinic/Center
  • High Point, NC
  • NPI 1750160867
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• New Hope Solutions & Wellness Center

  • Community/Behavioral Health Agency
  • Eden, NC
  • NPI 1447892088
  NPD
• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1932300019
  NPD

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1427607308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276100114",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3117 Poplarwood Ct Ste 115",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276041040",
            "country_code": "US",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 N Corcoran St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277015015",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "CAEDORA",
        "middle_name": "MARYLOUISE",
        "name_prefix": "Mrs.",
        "credential": "NP, PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "264004",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012193",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183725",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAEDORA",
            "last_name": "GARDNER",
            "middle_name": "MARYLOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra Denise Bentley, M.D.
• Lindsay Sawyer Bentley, PHYSICIAN ASSISTANT
• Mary Carr Allen Bentley, PA
• Benton S Satterfield MD PA
• Ashley Eva Benton, LCSW
• Courtney Benton
• John William Benton, CADC, ICADC
• Isabella D Bentsen, MD
• Zachary Bentz, PHARMD
• Anne Elizabeth Berardi, PHARM.D.

• Psychiatric/Mental Health Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.