Individual provider Active NPI

Farah Edwidge Johanne Sajous, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1609344977
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
50114431 Issued in NC
Practice address
2627 Grimsley St
Greensboro, NC 27403-3135
Phone
(336) 279-1227
Fax
(336) 279-1226
NPI assigned
Nov 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 50114431 NC
Case Manager/Care Coordinator 171M00000X 11000030 FL
Community/Behavioral Health Agency 251S00000X 50114431 NC
Community/Behavioral Health Agency 251S00000X 11000030 FL
Nurse Practitioner 363L00000X 50114431 NC
Nurse Practitioner 363L00000X 11000030 FL
Adult Health Nurse Practitioner 363LA2200X 50114431 NC
Adult Health Nurse Practitioner 363LA2200X 11000030 FL
Community Health Nurse Practitioner 363LC1500X 50114431 NC
Community Health Nurse Practitioner 363LC1500X 11000030 FL
Family Nurse Practitioner 363LF0000X 11000030 FL
Pediatric Nurse Practitioner 363LP0200X 50114431 NC
Pediatric Nurse Practitioner 363LP0200X 11000030 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11000030 FL
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 50114431 NC Primary

Addresses

Primary practice location

2627 Grimsley St
Greensboro, NC 27403-3135

Mailing address

2627 Grimsley St
Greensboro, NC 27403-3135

Other practice location 1

9351 Pinto Dr
Lake Worth, FL 33467
Phone (571) 432-6769

Other practice location 2

2627 Grimsley St
Greensboro, NC 27403-3135
Phone (336) 279-1227

Other identifiers 1

IdentifierTypeStateIssuer
1609344977MedicaidNC

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
I20190325001349 NC Practitioner - Nurse Practitioner 4981944295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2627 Grimsley St
Greensboro, NC 27403-3135
Phone (336) 279-1227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000030FLMDPsychiatric/Mental Health Nurse Practitioner
50114431NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Quest Care Services, LLC Multi-Specialty CurrentSince Feb 27, 2019 Accepting new patients

Locations

708 Summit Ave
Greensboro, NC 27405
Phone (336) 279-1227

2627 Grimsley St
Greensboro, NC 27403
Phone (336) 255-8203

Organizations & group practices 1

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1609344977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 GRIMSLEY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274033135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 GRIMSLEY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274033135",
            "telephone_number": "336-279-1227",
            "fax_number": "336-279-1226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9351 Pinto Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "33467",
            "country_code": "US",
            "telephone_number": "571-432-6769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2627 Grimsley St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274033135",
            "country_code": "US",
            "telephone_number": "336-279-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAJOUS",
        "first_name": "FARAH",
        "middle_name": "EDWIDGE JOHANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "50114431",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11000030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "50114431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609344977",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.