Active NPI
Ijeoma Nwankwo
- Adult Care Home Facility
- Raleigh, NC
National Provider Identifier
1154571511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 092648
- Practice address
- 1108 Seabrook Rd
Raleigh, NC 27610-5738 - Phone
- (336) 253-2219
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 092648 | NC | Primary |
Addresses
Primary practice location
1108 Seabrook Rd
Raleigh, NC 27610-5738
Mailing address
4428 Louisburg Rd
Suite 109
Raleigh, NC 27616-4302
Phone (336) 253-2219
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
| License | State | Type | Specialty |
|---|---|---|---|
| 092648 | NC | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1154571511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4428 LOUISBURG RD",
"address_2": "SUITE 109",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276164302",
"telephone_number": "336-253-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 SEABROOK RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276105738",
"telephone_number": "336-253-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWANKWO",
"first_name": "IJEOMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NC",
"license": "092648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.