Eomba Pungu, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F07171211 Issued in NC

Practice address

2905 Freedom Dr
Charlotte, NC 28208-3857

Phone

(704) 394-3033

NPI assigned

Aug 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cornerstone Medical Clinic PCGroup PAC ID 8628020062, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cornerstone Medical Clinic PC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1043210099
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• Freedom Medical Clinic & Urgent Care PA

  • Primary Care Clinic/Center
  • Charlotte, NC
  • NPI 1255450235
  NPD (past)
• Graces Community Healthcare Inc

  • Community Health Clinic/Center
  • Charlotte, NC
  • NPI 1497399802
  NPD (past)

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1174047070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 EAGLE PEAK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142226",
            "telephone_number": "704-244-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 FREEDOM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083857",
            "telephone_number": "704-394-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNGU",
        "first_name": "EOMBA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F07171211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pulse Sport Wear Inc
• Pulse Sportz Foundation Inc
• Pulsesportz Foundation
• Emily Puma
• Kristine Ann Pumpa, DPT
• Tsha Edith Pungu
• Ashwini Mhatre Punjabi, M.D.
• Kelash Kumar Punjabi, MD
• Omar Suresh Punjabi, M.D.
• Manvi Punukollu

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.