Individual provider Active NPI

Grace Peace Niyonkuru

  • Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1023746484
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5016698 Issued in NC
Practice address
3480 Wake Forest Rd Ste 404
Raleigh, NC 27609-7376
Phone
(919) 862-5730
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 5016698 NC Primary

Addresses

Primary practice location

3480 Wake Forest Rd Ste 404
Raleigh, NC 27609-7376

Mailing address

2316 Lantern Walk LN
Wake Forest, NC 27587-3411
Phone (412) 805-6995

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
I20221129002671 NC Practitioner - Nurse Practitioner 8527436336 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
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

3480 Wake Forest Rd
Raleigh, NC 27609-7376
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5016698NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. Single Specialty CurrentSince May 15, 2023 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

3480 Wake Forest Rd
Ste 404
Raleigh, NC 27609
Phone (919) 684-3834

3480 Wake Forest Rd
Ste 1
Raleigh, NC 27609

Interoperability endpoints

  • Direct secure messaging: guwamahoro222275@direct.medicine.duke.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1023746484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 LANTERN WALK LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873411",
            "telephone_number": "412-805-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 WAKE FOREST RD STE 404",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097376",
            "telephone_number": "919-862-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIYONKURU",
        "first_name": "GRACE",
        "middle_name": "PEACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.