Individual provider Active NPI

Mardisha Stella Simpson, ADN,BS,RHIT,NP,MD,MA

Student in an Organized Health Care Education/Training Program
Charlotte, NC

National Provider Identifier

1477497576

Registry record updated May 9, 2026

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Charlotte, NC
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License: SI9848238 Issued in NC
Practice address: 915 Pearl Park Way
Charlotte, NC 28204-0073
Phone: (704) 907-9921
NPI assigned: Apr 17, 2026
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on May 9, 2026

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

Specialties & licenses 11

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X	940389678	NC
Student in an Organized Health Care Education/Training Program	390200000X	L46320870	MI
Student in an Organized Health Care Education/Training Program	390200000X	16507430	NC
Student in an Organized Health Care Education/Training Program	390200000X	4202053	NC
Student in an Organized Health Care Education/Training Program	390200000X	36630	NC
Student in an Organized Health Care Education/Training Program	390200000X	4104801506	NC
Student in an Organized Health Care Education/Training Program	390200000X	8698989	NC
Community Health Registered Nurse	163WC1500X	01366839	NC
Student in an Organized Health Care Education/Training Program	390200000X	SI9848238	NC	Primary
Student in an Organized Health Care Education/Training Program	390200000X	519252368	NC
Student in an Organized Health Care Education/Training Program	390200000X	13871770	TN

Addresses

Primary practice location

915 Pearl Park Way
Charlotte, NC 28204-0073

Mailing address

5023 Riverdale Dr
Charlotte, NC 28273-8912

Other practice location 1

1201 Elizabeth Ave
Charlotte, NC 28204-2240
Phone (704) 330-2722

Other practice location 2

6397 Lee Hwy
Chattanooga, TN 37421-2564
Phone (423) 305-7781

Other practice location 3

4601 Charlotte Park Dr Ste 340
Charlotte, NC 28217-1920
Phone (704) 523-2617

Other practice location 4

4444 2nd Ave # 36001
Detroit, MI 48201-1216
Phone (332) 334-8285

Other practice location 5

5943 South Blvd
Charlotte, NC 28217-4123
Phone (704) 553-4191

Other practice location 6

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

Electronic endpoints 13

Type	Endpoint	Use
CONNECT URL	https://www.cmsk12.org/board	Direct
CONNECT URL	https://chattanoogacollege.edu/	Direct
CONNECT URL	https://libertyhealthandrehab.com/pavilionhealthcenter/	Direct
CONNECT URL	https://www.aamc.org/	Direct
CONNECT URL	https://www.stepful.com/	Direct
CONNECT URL	https://fap.lsac.org/standards/instructions.aspx?section_id=4741728	Direct
CONNECT URL	https://school.wakehealth.edu/about-the-school/facilities-and-environment/learning-environment/charlotte	Direct
CONNECT URL	https://atriumhealth.org/education/carolinas-college-of-health-sciences/academic-programs	Direct
CONNECT URL	https://www.miller-motte.edu/	Direct
CONNECT URL	https://engr.charlotte.edu/admissions/undergraduate-admissions/
CONNECT URL	https://www.cmsk12.org/board	Direct
CONNECT URL	wfu.edu	Direct
CONNECT URL	https://www.cpcc.edu/	Direct

Medicare participation

Medicare enrollment files

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

National Provider Directory

Medicare enrollment (NPD): Not enrolled
Credentials: Bachelor of Science, Master of Arts, Doctor of Medicine, Nurse Practitioner

State licenses

License	State	Type	Specialty
01366839	NC	MD	Community Health Registered Nurse
36630	NC	MD	Orthopaedic Surgery Physician
L46320870	MI	MD	Student in an Organized Health Care Education/Training Program
16507430	NC	MD	Student in an Organized Health Care Education/Training Program
4104801506	NC	MD	Student in an Organized Health Care Education/Training Program
4202053	NC	MD	Student in an Organized Health Care Education/Training Program
519252368	NC	MD	Student in an Organized Health Care Education/Training Program
8698989	NC	MD	Student in an Organized Health Care Education/Training Program
940389678	NC	MD	Student in an Organized Health Care Education/Training Program
SI9848238	NC	MD	Student in an Organized Health Care Education/Training Program
13871770	TN	MD	Student in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1776384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1477497576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 RIVERDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282738912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 PEARL PARK WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282040073",
            "telephone_number": "704-907-9921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Elizabeth Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042240",
            "country_code": "US",
            "telephone_number": "704-330-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6397 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374212564",
            "country_code": "US",
            "telephone_number": "423-305-7781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4601 Charlotte Park Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282171920",
            "country_code": "US",
            "telephone_number": "704-523-2617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4444 2nd Ave # 36001",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011216",
            "country_code": "US",
            "telephone_number": "332-334-8285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5943 South Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282174123",
            "country_code": "US",
            "telephone_number": "704-553-4191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10648 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-667-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "MARDISHA",
        "middle_name": "STELLA",
        "credential": "ADN,BS,RHIT,NP,MD,MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "940389678",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "L46320870",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "16507430",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "4202053",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "36630",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "4104801506",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "8698989",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NC",
            "license": "01366839",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "SI9848238",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "519252368",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "13871770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cmsk12.org/board",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4301 Sandy Porter Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282733214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://chattanoogacollege.edu/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6397 Lee Hwy",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374212564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://libertyhealthandrehab.com/pavilionhealthcenter/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10011 Providence Rd W",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282771561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.aamc.org/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4601 Charlotte Park Dr Ste 340",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282171920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.stepful.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4444 2nd Ave # 36001",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482011216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://fap.lsac.org/standards/instructions.aspx?section_id=4741728",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 S State St",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481093091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://school.wakehealth.edu/about-the-school/facilities-and-environment/learning-environment/charlotte",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "235 Innovate Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://atriumhealth.org/education/carolinas-college-of-health-sciences/academic-programs",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "915 Pearl Park Way",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282040073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.miller-motte.edu/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6397 Lee Hwy",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374212564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://engr.charlotte.edu/admissions/undergraduate-admissions/",
            "affiliation": "N",
            "address_1": "9201 University City Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282230001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cmsk12.org/board",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8900 Park Rd United States",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wfu.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1834 Wake Forest Rd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271096000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cpcc.edu/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 Elizabeth Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; 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.