Individual provider Active NPI

Shauntil Couch-Bah, FNP

  • Nurse Practitioner
  • Durham, NC
National Provider Identifier
1033087218
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5023419 Issued in NC
Practice address
4205 Amber Stone Way
Durham, NC 27704-6411
Phone
(919) 884-0872
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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 5023419 NC Primary

Addresses

Primary practice location

4205 Amber Stone Way
Durham, NC 27704-6411

Mailing address

4205 Amber Stone Way
Durham, NC 27704-6411
Phone (919) 884-0872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5023419NCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1033087218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 AMBER STONE WAY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277046411",
            "telephone_number": "919-884-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 AMBER STONE WAY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277046411",
            "telephone_number": "919-884-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH-BAH",
        "first_name": "SHAUNTIL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5023419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.