Active NPI
Nneka Asiegbunam
- Psychiatric/Mental Health Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1265036537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 5013887
- Practice address
- 413 Campus St
Charlotte, NC 28216-5305 - Phone
- (704) 430-5612
- NPI assigned
- Nov 26, 2020
- Last updated
- Jan 26, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5013887 | NC | Primary |
| Registered Nurse | 163W00000X | 260169 | NC |
Addresses
Primary practice location
413 Campus St
Charlotte, NC 28216-5305
Mailing address
413 Campus St
Charlotte, NC 28216-5305
Phone (704) 430-5612
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260169 | NC | MD | Registered Nurse |
| 5013887 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current | Accepting new patients |
Locations
555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Organizations & group practices 1
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": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1265036537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 CAMPUS ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282165305",
"telephone_number": "704-430-5612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 CAMPUS ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282165305",
"telephone_number": "704-430-5612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASIEGBUNAM",
"first_name": "NNEKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-26",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "5013887",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "260169",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.