Individual provider Active NPI

Rose Kisembo Nyakairu

  • Adult Health Nurse Practitioner
  • Holly Springs, NC
National Provider Identifier
1326611484
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NYAK-KXCEJ Issued in NC
Practice address
205 Begonia TRL
Holly Springs, NC 27540-4407
Phone
(919) 389-9664
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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 NYAK-KXCEJ NC Primary

Addresses

Primary practice location

205 Begonia TRL
Holly Springs, NC 27540-4407

Mailing address

205 Begonia TRL
Holly Springs, NC 27540-4407
Phone (919) 389-9664

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
I20211021000577 NC Practitioner - Nurse Practitioner 5496143646 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ih Physician Services PCGroup PAC ID 5991165458, 56 clinicians

Practice addresses (Care Compare)

Raleigh, NC 27609
Phone (984) 328-7736

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NYAK-KXCEJNCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
In Home Health, LLC CurrentSince Jul 3, 2023 Accepting new patients
Ih Physician Services PC CurrentSince Oct 31, 2023 Accepting new patients
In Home Health LLC CurrentSince Jul 3, 2023 Accepting new patients
Ih Physician Services, PC CurrentSince Oct 31, 2023 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Sep 14, 2021 Accepting new patients
Ih Physician Services PC Past Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

4505 Falls of Neuse Rd
Ste 650
Raleigh, NC 27609
Phone (919) 877-9959

4515 Falls of Neuse Rd
Ste 420
Raleigh, NC 27609
Phone (919) 877-9959

100 Pavilion Way
Ste E4
Southern Pnes, NC 28387
Phone (910) 684-5078

L2540
Columbus, OH 43260

333 N Summit St
Fl 15
Toledo, OH 43604
Phone (419) 252-5530

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1326611484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BEGONIA TRL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404407",
            "telephone_number": "919-389-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BEGONIA TRL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404407",
            "telephone_number": "919-389-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAKAIRU",
        "first_name": "ROSE",
        "middle_name": "KISEMBO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "NYAK-KXCEJ",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.