Individual provider Active NPI

Ike Osuorji

  • Intellectual & Developmental Disabilities Psychologist
  • Durham, NC
National Provider Identifier
1467906115
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
1717 N Alston Ave
Durham, NC 27701-2301
Phone
(919) 641-2791
Fax
(984) 219-6212
NPI assigned
Aug 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

1717 N Alston Ave
Durham, NC 27701-2301

Mailing address

4901 Paces Ferry Dr
Durham, NC 27712-4103
Phone (919) 641-2791

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy'S Home Care Agency Current Accepting new patients
Mercy'S Home Care Agency Current Accepting new patients
PP&V Health Care Solutions LLC Past Accepting new patients

Organizations & group practices 3

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": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1467906115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 PACES FERRY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277124103",
            "telephone_number": "919-641-2791",
            "fax_number": "984-219-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277012301",
            "telephone_number": "919-641-2791",
            "fax_number": "984-219-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUORJI",
        "first_name": "IKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.