Individual provider Active NPI

Jennifer Omohundro

  • Family Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1023468303
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008630 Issued in NC
Practice address
1331 N Elm St Ste 200
Greensboro, NC 27401-6304
Phone
(336) 274-6682
Fax
(336) 274-8097
NPI assigned
Jun 16, 2016
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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 5008630 NC Primary

Addresses

Primary practice location

1331 N Elm St Ste 200
Greensboro, NC 27401-6304

Mailing address

PO Box 85378
Chicago, IL 60689-5378
Phone (336) 274-6682

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
I20160823000085 NC Practitioner - Nurse Practitioner 7315232964 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians
Diagnostic Radiology and Imaging LLCGroup PAC ID 4183517097, 87 clinicians

Practice addresses (Care Compare)

1331 N Elm St
Suite 200
Greensboro, NC 27401-6304
Phone (336) 274-6682

315 W Wendover Ave
Greensboro, NC 27408-8401
Phone (336) 433-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008630NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiology & Imaging LLC CurrentSince Nov 1, 2020 Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Aug 23, 2017 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 8, 2017 Accepting new patients
Greensboro Radiology, PA CurrentSince Nov 1, 2020 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Aug 23, 2017 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 8, 2017 Accepting new patients

Locations

375 Sunset Ave
Asheboro, NC 27203
Phone (336) 625-4215

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

4030 Oaks Professional Pkwy
Ste 101
Burlington, NC 27215

1002 N Church St
Ste 401
Greensboro, NC 27401
Phone (336) 271-4999

1123 N Church St
Greensboro, NC 27401
Phone (336) 832-4400

1126 N Church St
Ste 200
Greensboro, NC 27401
Phone (336) 379-0941

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

301 E Wendover Ave
Ste 300
Greensboro, NC 27401
Phone (336) 268-3380

315 W Wendover Ave
Greensboro, NC 27408
Phone (336) 273-0530

3711 Elmsley St
Ste 102
Greensboro, NC 27406
Phone (336) 890-2200

1814 Westchester Dr
Ste 100
High Point, NC 27262
Phone (336) 802-2397

Interoperability endpoints

  • Direct secure messaging: jomohundro2791838@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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 2

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1023468303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85378",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895378",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016304",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOHUNDRO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.