Individual provider Active NPI

Cassidy McRorie, PNP-PC

  • Pediatric Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1518636760
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5020051 Issued in TN
Practice address
10940 Raven Ridge Rd
Raleigh, NC 27614-6610
Phone
(540) 505-6894
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5020051 TN Primary

Addresses

Primary practice location

10940 Raven Ridge Rd
Raleigh, NC 27614-6610

Mailing address

10940 Raven Ridge Rd Ste 200
Raleigh, NC 27614-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20220317001923 TN Practitioner - Nurse Practitioner 0042605651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30033TNMDSurgery Physician
5020051TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Children'S Research Hospital, Inc. Pediatrics CurrentSince Dec 10, 2021 Accepting new patients
Durant Road Pediatrics CurrentSince Oct 6, 2024 Accepting new patients

Locations

10940 Raven Ridge Rd
Raleigh, NC 27614
Phone (919) 380-0964

10880 Durant Rd
Ste 215
Raleigh, NC 27614
Phone (919) 205-4410

10940 Raven Ridge Rd
Ste 200
Raleigh, NC 27614
Phone (919) 205-4410

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1518636760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 RAVEN RIDGE RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10940 RAVEN RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146610",
            "telephone_number": "540-505-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRORIE",
        "first_name": "CASSIDY",
        "credential": "PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "5020051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.