NPIMap

Individual provider Active NPI

Cindy Cheng-Ja Southerland, RN, ANP, GNP

  • Nurse Practitioner
  • Durham, NC
National Provider Identifier
1730481763
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004996 Issued in NC
Practice address
Dumc Brain Tumor Ctr
047 Baker House, Trent Drive
Durham, NC 27710-0001
Phone
(919) 668-2447
Fax
(919) 613-6329
NPI assigned
Nov 24, 2010
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004996 NC Primary

Addresses

Primary practice location

Dumc Brain Tumor Ctr
047 Baker House, Trent Drive
Durham, NC 27710-0001

Mailing address

Dumc
047 Baker House, Trent Drive, Box 3624
Durham, NC 27710-0001
Phone (919) 668-2447

Other names 1

  • Cindy Cheng-Ja Lu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000347 NC Practitioner - Nurse Practitioner 8820272206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

20 Duke Medicine Cir
Durham, NC 27710-2000
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
5004996NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

20 Duke Medicine Cir
Durham, NC 27710
Phone (919) 668-6608

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

Interoperability endpoints

  • Direct secure messaging: csoutherland48603@direct.medicine.duke.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1730481763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DUMC",
            "address_2": "047 BAKER HOUSE, TRENT DRIVE, BOX 3624",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-668-2447",
            "fax_number": "919-613-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DUMC BRAIN TUMOR CTR",
            "address_2": "047 BAKER HOUSE, TRENT DRIVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-668-2447",
            "fax_number": "919-613-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "CINDY",
        "middle_name": "CHENG-JA",
        "credential": "RN, ANP, GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "LU",
            "middle_name": "CHENG-JA",
            "credential": "RN, ANP, GNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.