Individual provider Active NPI

Christian Nkemnkia, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1043922438
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5017377 Issued in NC
Practice address
10901 World Trade Blvd
Raleigh, NC 27617-4203
Phone
(919) 746-8900
NPI assigned
Dec 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5017377 NC Primary

Addresses

Primary practice location

10901 World Trade Blvd
Raleigh, NC 27617-4203

Mailing address

439 Stapleford LN
Fuquay Varina, NC 27526-1883
Phone (248) 719-2771

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
I20230306001173 NC Practitioner - Nurse Practitioner 9133592595 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)

10901 World Trade Blvd
Raleigh, NC 27617-4203
Phone (919) 746-8900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017377NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Springs Physician Group, LLC CurrentSince Feb 6, 2023 Accepting new patients
Authentic Hands Home Care, LLC CurrentSince Dec 28, 2022 Accepting new patients

Locations

10901 World Trade Blvd
Raleigh, NC 27617
Phone (919) 272-1026

Organizations & group practices 2

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1043922438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 STAPLEFORD LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261883",
            "telephone_number": "248-719-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 WORLD TRADE BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276174203",
            "telephone_number": "919-746-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEMNKIA",
        "first_name": "CHRISTIAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5017377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.