Individual provider Active NPI

Martha Kerubo Ochako, PMHNP

  • Psychiatric/Mental Health Registered Nurse
  • Raleigh, NC
National Provider Identifier
1497417844
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
281419 Issued in NC
Practice address
319 Chapanoke Rd Ste 120
Raleigh, NC 27603-3433
Phone
(919) 703-2845
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 281419 NC Primary

Addresses

Primary practice location

319 Chapanoke Rd Ste 120
Raleigh, NC 27603-3433

Mailing address

319 Chapanoke Rd Ste 120
Raleigh, NC 27603-3433
Phone (919) 703-2845

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
I20241015003319 NC Practitioner - Nurse Practitioner 0547792525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
281419NCMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Abundant Mental Health Support PLLC Current Accepting new patients
Robert C. Pennebaker PLLC CurrentSince Sep 1, 2024 Accepting new patients
Abundant Life Health Support Current Accepting new patients

Locations

2931 Breezewood Ave
Ste 104
Fayetteville, NC 28303
Phone (910) 491-1134

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1497417844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 CHAPANOKE RD STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033433",
            "telephone_number": "919-703-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 CHAPANOKE RD STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033433",
            "telephone_number": "919-703-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCHAKO",
        "first_name": "MARTHA",
        "middle_name": "KERUBO",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NC",
            "license": "281419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.