Individual provider Active NPI

Kongit Achew, AGNP

  • Adult Health Nurse Practitioner
  • Concord, NC
National Provider Identifier
1487365151
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5017340 Issued in NC
Practice address
413 Winecoff School Rd
Concord, NC 28027-4175
Phone
(704) 788-2131
NPI assigned
Dec 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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 5017340 NC Primary

Addresses

Primary practice location

413 Winecoff School Rd
Concord, NC 28027-4175

Mailing address

5409 Perry June Ave
Charlotte, NC 28213-5368
Phone (404) 259-4878

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
I20221227000162 NC Practitioner - Nurse Practitioner 9638549207 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017340NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Wholehealth Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
True Joy Assisted Living, LLC Current Accepting new patients

Locations

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

Organizations & group practices 2

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": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1487365151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 PERRY JUNE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135368",
            "telephone_number": "404-259-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 WINECOFF SCHOOL RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280274175",
            "telephone_number": "704-788-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHEW",
        "first_name": "KONGIT",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5017340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.