Individual provider Active NPI

Joy Atufunwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Roanoke Rapids, NC
National Provider Identifier
1306457536
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
248263 Issued in NC
Practice address
109 Long Cir
Roanoke Rapids, NC 27870-3162
Phone
(270) 535-6400
NPI assigned
Aug 11, 2020
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 248263 NC Primary

Addresses

Primary practice location

109 Long Cir
Roanoke Rapids, NC 27870-3162

Mailing address

109 Long Cir
Roanoke Rapids, NC 27870-3162
Phone (270) 535-6400

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
I20210510001127 NC Practitioner - Nurse Practitioner 4486064557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
248263NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Life Behavioral Care LLC CurrentSince Jan 28, 2021 Accepting new patients

Locations

109 Long Cir
Roanoke Rapids, NC 27870
Phone (252) 535-6400

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1306457536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LONG CIR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703162",
            "telephone_number": "270-535-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LONG CIR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703162",
            "telephone_number": "270-535-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATUFUNWA",
        "first_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "248263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.