Active NPI
Idara Ndoh
- Case Manager/Care Coordinator
- Melbourne, FL
National Provider Identifier
1366149163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1600 Sarno Rd Ste 119J
Melbourne, FL 32935-4938 - Phone
- (321) 414-2248
- Fax
- (877) 515-0334
- NPI assigned
- Feb 13, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | FL | Primary |
Addresses
Primary practice location
1600 Sarno Rd Ste 119J
Melbourne, FL 32935-4938
Mailing address
125 Remount Rd
Suite C1 #568
Charlotte, NC 28203
Phone (850) 545-9063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720617335 | Other | FL | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1366149163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 REMOUNT RD",
"address_2": "SUITE C1 #568",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28203",
"telephone_number": "850-545-9063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SARNO RD STE 119J",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329354938",
"telephone_number": "321-414-2248",
"fax_number": "877-515-0334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDOH",
"first_name": "IDARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1720617335",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.