Individual provider Active NPI

Kimberly Ritenour

  • Psychiatric/Mental Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1912665340
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5014650 Issued in NC
Practice address
3911 New Bern Ave
Raleigh, NC 27610-1332
Phone
(199) 480-3009
NPI assigned
Dec 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5014650 NC Primary
Family Nurse Practitioner 363LF0000X 5014650 NC

Addresses

Primary practice location

3911 New Bern Ave
Raleigh, NC 27610-1332

Mailing address

3911 New Bern Ave
Raleigh, NC 27610-1332

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
I20260218003319 NC Practitioner - Nurse Practitioner 8123516010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedar Oaks Clinic PLLCGroup PAC ID 0547678500, 9 clinicians

Practice addresses (Care Compare)

1748 Heritage Ctr Dr
Suite 101
Wake Forest, NC 27587-9855
Phone (919) 529-5920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5014650NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Oaks Clinic PLLC CurrentSince Jan 23, 2026 Accepting new patients
Metro Treatment of North Carolina L P PastSince Jun 30, 2024 Accepting new patients
Metro Treatment of North Carolina L P PastSince Jun 30, 2024 Accepting new patients

Locations

1748 Heritage Center Dr
Ste 101
Wake Forest, NC 27587
Phone (919) 529-5920

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1912665340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101332",
            "telephone_number": "199-480-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITENOUR",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5014650",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.