Chike Christopher Ifediorah, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5011513 Issued in NC

Practice address

1300 Western Blvd
Raleigh, NC 27606-2148

Phone

(919) 743-2321

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Gova Healthcare Services LLC.

  • Home Health Agency
  • Raleigh, NC
  • NPI 1689483927
  NPD Authorized official

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1548733934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 SKYBROOK LN",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035977",
            "telephone_number": "919-949-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WESTERN BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062148",
            "telephone_number": "919-743-2321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 Skybrook Ln",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277035977",
            "country_code": "US",
            "telephone_number": "919-949-8956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IFEDIORAH",
        "first_name": "CHIKE",
        "middle_name": "CHRISTOPHER",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NC",
            "license": "287100",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "287100",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5011513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Joy Idichandy, MS, BCBA, LBA
• Idler Spine, PLLC
• Cary Scott Idler, MD
• Oluwole Adetola Idowu, FNP-C
• Ifcs
• Pearlette Johnae Ifill
• Fantasy Afia Ifversen-Davis
• Vincent C Igboekwe, MD
• Rania Ighwair, RD
• Jennifer Marks Iglio, MS, CCC-SLP

• Adult Health Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.