Carol Sue Raynor

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201761 Issued in NC

Practice address

114 Memorial Dr Ste a
Jacksonville, NC 28546-6328

Phone

(910) 353-0700

Fax

(910) 353-5305

NPI assigned

Jul 8, 2006

Last updated

Nov 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Carol Sue Holland Former name

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

Specialty

Nurse Practitioner

Education

University of North Carolina at Chapel Hill School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Children's and Multispecialty Clinic, PAGroup PAC ID 6709968811, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacksonville Children's and Multispecialty Clinic, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1164519070
  Medicare reassignment Care Compare group NPD
• Amm Healthcare, PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1528639689
  NPD
• Emergency Physician Associates of North Carolina, P.C.

  • Emergency Medicine Physician
  • Jacksonville, NC
  • NPI 1306887609
  NPD (past)
• Family Care Clinic, P.a.

  • Clinic/Center
  • Jacksonville, NC
  • NPI 1316033590
  NPD (past)
• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1447283098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MEMORIAL DR STE A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-0700",
            "fax_number": "910-353-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "CAROL",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201761",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "117615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "HOLLAND",
            "middle_name": "SUE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn Rasmussen
• Amber Ratchford, MD
• Blake Austin Rauch, DPT
• Jessica Ravan, RBT
• Raven Therapeutic Services, PLLC
• Elizabeth Jenkins Raynor, FNP-BC
• Dominic Michael Reali, DPT
• Realo Discount Drug of Onslow
• Realo Discount Drug Stores of Eastern North Carolina, Inc. (Realo Discount Drugs)
• Realo Discount Drugs of Onslow Inc (Realo Discount Drugs)

• Nurse Practitioner in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.