Organization Active NPI

Renewal Health & Recovery Clinic

  • Mental Health Counselor
  • Cary, NC
National Provider Identifier
1083575310
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RENEWAL HEALTH & RECOVERY CLINIC
Practice address
1140 Kildaire Farm Rd
Cary, NC 27511-4562
Phone
(339) 229-2392
NPI assigned
Nov 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Ambrose Oyemhen UkpeborNPI 1790664944
Title
NP
Phone
(339) 229-2392

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1140 Kildaire Farm Rd
Cary, NC 27511-4562

Mailing address

417 Durants Neck LN
Morrisville, NC 27560-5852
Phone (339) 229-2392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260521004345 NC Part B Supplier - Clinic/Group Practice 0244700094 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1083575310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 DURANTS NECK LN",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605852",
            "telephone_number": "339-229-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 KILDAIRE FARM RD",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114562",
            "telephone_number": "339-229-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL HEALTH & RECOVERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "UKPEBOR",
        "authorized_official_first_name": "AMBROSE",
        "authorized_official_middle_name": "OYEMHEN",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "339-229-2392"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.