David J Memmoli, APRN
Individual provider Active NPI Family Nurse Practitioner · Raleigh, NC
NPI 1891978607 · NPPES record last updated Apr 23, 2025
Key facts
- NPI
- 1891978607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5017310 (NC)
- Practice address
- 2340 Spring Forest Rd
Raleigh, NC 27615-7528 - Phone
- (702) 656-0016
- Fax
- (702) 933-8690
- NPI assigned
- Dec 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivy Medical Group PLLC
Practice addresses (Care Compare)
885 3Rd Ave
FL 28
New York, NY 10022-4834
Phone (212) 734-6621
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (21 enrollments) in WV, PA, NV, AZ, MI, FL, OH, TX, TN, NY, ME, DC, NJ, NH, NC, VA, CT, IA, NE, MD, DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100811000438 | WV | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20110610000278 | PA | Practitioner - Nurse Practitioner | 0244364347 | |
| I20121204000173 | NV | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
| I20200416003989 | AZ | Practitioner - Nurse Practitioner | 0244364347 | |
| I20230711003554 | MI | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 2 organizations |
| I20230714001082 | FL | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 7 organizations |
| I20230714002189 | OH | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20230714002565 | TX | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 2 organizations |
| I20230714003153 | TN | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 4 organizations |
| I20241120002413 | NY | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20250311002663 | ME | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20250318001696 | DC | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20250324002431 | NJ | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 5 organizations |
| I20250415002709 | NH | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 3 organizations |
| I20250430001799 | NC | Practitioner - Nurse Practitioner | 0244364347 | |
| I20250528000249 | VA | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
| I20250602000952 | CT | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
| I20250806000538 | IA | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
| I20250806001308 | NE | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
| I20260224002672 | MD | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 2 organizations |
| I20260224004329 | DE | Practitioner - Nurse Practitioner | 0244364347 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC004504 | MD | MD | Internal Medicine Physician |
| 5017310 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Careathome Medical Practice NJ | Current |
Accepting new patients | |
| Gracious Minds Counseling and Supervision Inc. | Current |
Accepting new patients | |
| MC Diagnostic of Connecticut, P.C. | Family | Current |
Accepting new patients |
| Caringathome, LLC | Family | Current |
Accepting new patients |
| Lumina Care Medical NJ LLC | Current |
Accepting new patients | |
| Primary Care PLLC | Family | Current |
Accepting new patients |
| Dr Rebman Medical PA | Current |
Accepting new patients | |
| Nurocoach Medical Group PLLC | Current |
Accepting new patients | |
| Minuteclinic Diagnostic of Virginia LLC | Family | Current |
Accepting new patients |
| Minuteclinic Diagnostic of New Jersey LLC | Family | Current |
Accepting new patients |
| Careathome Medical Practice Ky | Family | Current |
Accepting new patients |
| Healthcare Partners Medical Group Coats LTD | Current | Accepting new patients | |
| Careathome Medical Practice | Family | Current |
Accepting new patients |
| Medical Group of New York, P.C. | Family | Current |
Accepting new patients |
| Five Star Medical Office PC | Current |
Accepting new patients | |
| Daniel Funsch Jr, M.D., P.C. | Current |
Accepting new patients | |
| Dr Rebman BH LLC | Current |
Accepting new patients | |
| Dr Medical Services PC | Current |
Accepting new patients | |
| Urgent Care Nevada, LLC | Current |
Accepting new patients | |
| Advanced Care Emergency Services, PLLC | Past | Accepting new patients | |
| Perfect Health PC | Past |
Accepting new patients |
Locations (25 of 44)
3514 Main St
Coventry, CT 06238
Phone (860) 298-5925
323 Cromwell Ave
Rocky Hill, CT 06067
Phone (860) 384-9666
715 E King St
Seaford, DE 19973
Phone (302) 536-5628
633 NE 167th St
Ste 301
North Miami Beach, FL 33162
111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257
1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336
100 S Ashley Dr
Ste 600
Tampa, FL 33602
Phone (813) 766-4218
699 Walnut St
Ste 411
Des Moines, IA 50309
Phone (888) 563-2823
9200 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 390-2600
300 Spring St
Westbrook, ME 04092
Phone (207) 856-1230
2723 S State St
Ste 150
Ann Arbor, MI 48104
Phone (734) 316-7880
418 N Main St
Fl 2
Royal Oak, MI 48067
Phone (586) 786-8080
2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401
6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415
1299 Farnam St
Ste 300
Omaha, NE 68102
Phone (402) 347-4191
20 Maitland St
Concord, NH 03301
Phone (516) 817-7093
25 E Lindsley Rd
Cedar Grove, NJ 07009
Phone (201) 647-8035
471 Main St
Chatham, NJ 07928
Phone (973) 635-4636
4 Ryan Rd
Marlboro, NJ 07746
Phone (732) 431-8700
28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519
55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744
307 Egg Harbor Rd
Sewell, NJ 08080
Phone (856) 589-1177
4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554
2202 W Craig Rd
North Las Vegas, NV 89032
Phone (702) 826-3200
107 S Country Rd
Bellport, NY 11713
Phone (631) 286-2222
Interoperability endpoints
- david.memmoli.1@30093.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5017310 | NC | Yes |
Addresses
Primary practice location
2340 Spring Forest Rd
Raleigh, NC 27615-7528
Mailing address
2340 Spring Forest Rd
Raleigh, NC 27615-7528
Other practice location 1
333 1st St Ste A
San Francisco, CA 94105-2661
Phone (888) 803-3370
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891978607 | Medicaid | NV |
Other providers in Raleigh, NC
- Katherine Melton
- Shannon Nicole Melton
- Daniel Nacy Meltzer
- Jacquetta Woods Melvin
- Melvyn Roy Berman, O.D., P.a
- Olivia Jane Bunce Menchinger
- Erin Kathleen Menday
- Matthew Mendel
- John Mendenhall II
- Robert R Mendes
All providers in Raleigh, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.