Active NPI
Maureen F Gonzales, NP
- Pediatric Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1891901559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 5004821
- Practice address
- 1520 Sunday Dr
Raleigh, NC 27607-5253 - Phone
- (919) 420-1653
- NPI assigned
- May 16, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 470 | SC | |
| Pediatric Nurse Practitioner | 363LP0200X | 5004821 | NC | Primary |
Addresses
Primary practice location
1520 Sunday Dr
Raleigh, NC 27607-5253
Mailing address
1540 Sunday Dr
Raleigh, NC 27607-6010
Phone (919) 782-3456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7004535 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgonzales@rna.medalliesdirect.net | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5004821 | NC | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1891901559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 SUNDAY DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076010",
"telephone_number": "919-782-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SUNDAY DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276075253",
"telephone_number": "919-420-1653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "MAUREEN",
"middle_name": "F",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2021-04-01",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "SC",
"license": "470",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NC",
"license": "5004821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7004535",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mgonzales@rna.medalliesdirect.net",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1520 Sunday Dr",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276075253",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.