Individual provider Active NPI

Carrie Gayle Ross, FNP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1972229193
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06222100 Issued in NC
Practice address
1390 Capital Blvd
Raleigh, NC 27603-1118
Phone
(919) 836-1642
NPI assigned
Oct 19, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06222100 NC Primary

Addresses

Primary practice location

1390 Capital Blvd
Raleigh, NC 27603-1118

Mailing address

1390 Capital Blvd
Raleigh, NC 27603-1118

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
I20241205001071 NC Practitioner - Nurse Practitioner 8022544774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

514 N Brightleaf Blvd
Suite 1100
Smithfield, NC 27577-4487
Phone (919) 989-2192

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F06222100NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston Specialty Physician Services,Inc CurrentSince Oct 8, 2024 Accepting new patients
Johnston Specialty Physician Services,Inc Current Accepting new patients
Johnston Specialty Physician Services,Inc Past Accepting new patients
Urban Ministries PastSince Oct 23, 2022 Accepting new patients
Urban Ministries of Wake County, Inc. PastSince Oct 23, 2022 Accepting new patients

Locations

2076 Veterans Pkwy
Ste 300
Clayton, NC 27520
Phone (919) 585-8835

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

514 N Brightleaf Blvd
Ste 1100
Smithfield, NC 27577
Phone (919) 939-2192

Interoperability endpoints

  • Direct secure messaging: carrie.ross.1@18383.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18383/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1972229193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 CAPITAL BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 CAPITAL BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031118",
            "telephone_number": "919-836-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CARRIE",
        "middle_name": "GAYLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F06222100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.