Individual provider Active NPI

Nyaradzo Ogunwo, NP

  • Adult Health Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1295185213
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5008643 Issued in NC
Practice address
1315 Aztek PL
Fayetteville, NC 28314-6112
Phone
(910) 723-5489
NPI assigned
Jun 21, 2016
Last updated
Jun 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5008643 NC Primary

Addresses

Primary practice location

1315 Aztek PL
Fayetteville, NC 28314-6112

Mailing address

1315 Aztek PL
Fayetteville, NC 28314-6112
Phone (910) 723-5489

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
I20160912002375 NC Practitioner - Nurse Practitioner 0648566968 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M Medical NC PLLCGroup PAC ID 3870035066, 32 clinicians

Practice addresses (Care Compare)

2727 Shamrock Dr
Charlotte, NC 28205-2215
Phone (704) 519-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008643NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 29, P.C. CurrentSince Dec 21, 2025 Accepting new patients
M Medical NC PLLC CurrentSince Apr 15, 2025 Accepting new patients
Cumberland County Hospital Systems, Inc CurrentSince Aug 1, 2016 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Aug 1, 2016 Accepting new patients

Locations

2727 Shamrock Dr
Charlotte, NC 28205
Phone (704) 519-2400

101 Robeson St
Ste 202
Fayetteville, NC 28301
Phone (910) 609-1630

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

17 Cornelia St
Lexington, NC 27292
Phone (336) 242-1349

1287 Newsome St
Mount Airy, NC 27030
Phone (336) 786-2133

Organizations & group practices 5

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1295185213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 AZTEK PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283146112",
            "telephone_number": "910-723-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 AZTEK PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283146112",
            "telephone_number": "910-723-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNWO",
        "first_name": "NYARADZO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5008643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.