Mary Lee Cudd, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0100900 Issued in NC

Practice address

1774 Metromedical Drive
Fayetteville, NC 28304

Phone

(910) 323-1203

Fax

(910) 323-3101

NPI assigned

Nov 1, 2006

Last updated

Jan 24, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cid PA

  dba Carolina Infectious Disease PA

  • Infectious Disease Physician
  • Fayetteville, NC
  • NPI 1588805188
  NPD (past)
• Fayetteville Plastic Surgery Specialists, PA

  • Plastic Surgery Physician
  • Fayetteville, NC
  • NPI 1093808388
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1730266453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 METROMEDICAL DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-323-1203",
            "fax_number": "910-323-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 METROMEDICAL DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-323-1203",
            "fax_number": "910-323-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDD",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0100900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nia'Lani Cruz
• Phoebe Marie Cruz, MD
• Cscldl, PC
• CT Maxillofacial Imaging, LLC
• Rosaura Cubas
• Diana Cueli, NP
• Sabrina Nicole Cuellar, FNP
• Kenneth Maurice Cuevas
• Jhonlie Cuis-Barnes, LMBT
• Khalyn Culbreath, BCABA

• Surgical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.