Individual provider Active NPI

Peter Ngosong, PSYCHIATRIC NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1063839892
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5015437 Issued in NC
Practice address
104 New Stateside Dr
Chapel Hill, NC 27516-1213
Phone
(919) 942-2803
NPI assigned
Mar 18, 2014
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 5015437 NC Primary

Addresses

Primary practice location

104 New Stateside Dr
Chapel Hill, NC 27516-1213

Mailing address

104 New Stateside Dr
Chapel Hill, NC 27516-1213
Phone (919) 942-2803

Other names 1

  • Peter Ngosong Professional name

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
I20220228000082 NC Practitioner - Nurse Practitioner 8729472220 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garner Behavioral Hospital LLCGroup PAC ID 4981072238, 23 clinicians

Practice addresses (Care Compare)

3200 Waterfield Dr
Garner, NC 27529-7727
Phone (919) 502-1187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015437NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Garner Behavioral Hospital, LLC CurrentSince Nov 27, 2023 Accepting new patients
Eleanor Health Professional NC, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Freedom House Recovery Center, Inc. Past Accepting new patients

Locations

2402 S Miami Blvd
Ste 101
Durham, NC 27703
Phone (919) 765-8730

3200 Waterfield Dr
Garner, NC 27529
Phone (919) 502-1187

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1063839892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161213",
            "telephone_number": "919-942-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161213",
            "telephone_number": "919-942-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGOSONG",
        "first_name": "PETER",
        "credential": "PSYCHIATRIC  NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5015437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "NGOSONG",
            "credential": "PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.