Individual provider Active NPI

Emmanuel Adjei Sowah, NP-C

  • Family Nurse Practitioner
  • Davidson, NC
National Provider Identifier
1376205682
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08210762 Issued in NC
Practice address
9942 Travertine TRL
Davidson, NC 28036-7654
Phone
(980) 319-7579
NPI assigned
Oct 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08210762 NC Primary

Addresses

Primary practice location

9942 Travertine TRL
Davidson, NC 28036-7654

Mailing address

9942 Travertine TRL
Davidson, NC 28036-7654
Phone (980) 319-7579

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
I20220222002322 NC Practitioner - Nurse Practitioner 3870987555 Reassigns benefits to 1 organization

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
Hospice of Iredell County IncGroup PAC ID 2961427018, 12 clinicians

Practice addresses (Care Compare)

2347 Simonton Rd
Statesville, NC 28625-8246
Phone (704) 873-4719

Hospital & facility affiliations

  • Gentiva Health Services Home health agency, Hickory, NC, CCN 347300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F08210762NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Iredell County, Inc CurrentSince Apr 19, 2023 Accepting new patients

Locations

2347 Simonton Rd
Statesville, NC 28625
Phone (704) 873-4719

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1376205682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9942 TRAVERTINE TRL",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367654",
            "telephone_number": "980-319-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9942 TRAVERTINE TRL",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367654",
            "telephone_number": "980-319-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWAH",
        "first_name": "EMMANUEL",
        "middle_name": "ADJEI",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F08210762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.