Individual provider Active NPI

Rudi Marshae Mack, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1881573855
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5024005 Issued in NC
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, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260330002337 NC Practitioner - Nurse Practitioner 0446735211 Reassigns benefits to 2 organizations

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
Recon Neurology and PsychiatryGroup PAC ID 3870965924, 20 clinicians

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

LicenseStateTypeSpecialty
5024005NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Womens Clinic PA CurrentSince Mar 10, 2026 Accepting new patients
Recon Neurology & Psychiatry CurrentSince Mar 10, 2026 Accepting new patients
Cumberland County Hospital System Inc PastSince Sep 8, 2025 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.