Active NPI
Rudi Marshae Mack, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Pinehurst, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 5024005
- Practice address
- 70 Memorial Dr
Pinehurst, NC 28374-8707 - Phone
- (910) 348-1192
- Fax
- (910) 348-1193
- NPI assigned
- Sep 2, 2025
- Last updated
- Aug 26, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5024005 | NC | Primary |
Addresses
Primary practice location
70 Memorial Dr
Pinehurst, NC 28374-8707
Mailing address
764 Walnut Knoll LN Ste 202
Cordova, TN 38018-3113
Phone (901) 756-5565
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
70 Memorial Dr
Pinehurst, NC 28374-1102
Phone (910) 348-1192
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5024005 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinehurst Womens Clinic PA | Current | Accepting new patients | |
| Recon Neurology & Psychiatry | Current | Accepting new patients | |
| Cumberland County Hospital System Inc | Past | Accepting new patients |
Locations
1340 Walter Reed Rd
Ste 201
Fayetteville, NC 28304
Phone (910) 401-5415
1340 Walter Reed Rd
Ste 202
Fayetteville, NC 28304
Phone (910) 504-3506
70 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-4342
764 Walnut Knoll Ln
Ste 202
Cordova, TN 38018
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GBCJCD
Organizations & group practices 4
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.
-
- Neurology Physician
- Fayetteville, NC
- NPI 1427769140
-
- Psychiatry Physician
- Greensboro, NC
- NPI 1134868300
-
- Obstetrics & Gynecology Physician
- Pinehurst, NC
- NPI 1427106186
-
dba Cape Fear Valley Professional Radiology Group
- Diagnostic Radiology Physician
- Fayetteville, NC
- NPI 1962299743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1881573855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "764 WALNUT KNOLL LN STE 202",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380183113",
"telephone_number": "901-756-5565",
"fax_number": "901-756-5564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 MEMORIAL DR",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283748707",
"telephone_number": "910-348-1192",
"fax_number": "910-348-1193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "RUDI",
"middle_name": "MARSHAE",
"name_prefix": "Ms.",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-02",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "5024005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.