Individual provider Active NPI

Cesar Nsumanganyi Kalombo, NP

  • Adult Health Nurse Practitioner
  • Reidsville, NC
National Provider Identifier
1568935039
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5011345 Issued in NC
Practice address
1123 S Main St
Reidsville, NC 27320-5339
Phone
(336) 342-4286
NPI assigned
Jan 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5011345 NC Primary
Gerontology Nurse Practitioner 363LG0600X 5011345 NC

Addresses

Primary practice location

1123 S Main St
Reidsville, NC 27320-5339

Mailing address

8 Shorthorn CT
Greensboro, NC 27405-9765
Phone (704) 890-2417

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
I20190307001842 NC Practitioner - Nurse Practitioner 3476892563 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The McInnis Clinic PLLCGroup PAC ID 9436423027, 2 clinicians

Practice addresses (Care Compare)

1123 S Main St
Suite C
Reidsville, NC 27320-5340
Phone (336) 342-4286

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5011345NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The McInnis Clinic PLLC CurrentSince Jan 30, 2019 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 15, 2022 Accepting new patients
Vitae Health Medical North Carolina, PLLC CurrentSince Oct 8, 2022 Accepting new patients

Locations

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

1123 S Main St
Reidsville, NC 27320
Phone (336) 342-1581

1123 S Main St
Ste C
Reidsville, NC 27320
Phone (336) 342-4286

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: cesar.kalombo.1@29598.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/29598/brand/1/csg/1/fhir/r4

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.

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": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1568935039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SHORTHORN CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274059765",
            "telephone_number": "704-890-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205339",
            "telephone_number": "336-342-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOMBO",
        "first_name": "CESAR",
        "middle_name": "NSUMANGANYI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5011345",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5011345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.