Active NPI
Keynadomnicia Chioma Udenze, AGNP-BC
- Adult Health Nurse Practitioner
- Garner, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 5009687
- Practice address
- 500 Benson Rd Ste 115
Garner, NC 27529-3947 - Phone
- (984) 246-2006
- Fax
- (984) 246-2005
- NPI assigned
- Jun 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP131087 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | 5009687 | NC | Primary |
Addresses
Primary practice location
500 Benson Rd Ste 115
Garner, NC 27529-3947
Mailing address
500 Benson Road
Suite 115
Garner, NC 27529-0016
Phone (214) 727-8681
Other practice location 1
5 Firstvillage drive
Pinehurst, NC 28374
Phone (910) 215-2520
Other practice location 2
3637 Cape Center Dr
Fayetteville, NC 28304-4457
Phone (910) 491-1760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP131087 | Other | TX | NURSE PRACTITIONER LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 B Veterans Blvd
Acoma, NM 87034-0080
Phone (505) 552-5300
East Hwy 18
Pine Ridge, SD 57770-1201
Phone (605) 867-3032
P O Box
Suite 1201
Pine Ridge, SD 57770-1201
P O Box 1201 E Hwy 18
Pine Ridge, SD 57770-1201
PO Box 1201 E Hwy 18
Pine Ridge, SD 57770-1201
Hospital & facility affiliations
- Pine Ridge IHS Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haaku Health | Multi-Specialty | Current | Accepting new patients |
| Gainesville Community Hospital, Inc. | Multi-Specialty | Current | Accepting new patients |
| Gainesville Community Hospital, Inc. | Multi-Specialty | Current | Accepting new patients |
| Universal Health Corporation | Multi-Specialty | Current | Accepting new patients |
| Theoria Medical | Multi-Specialty | Current | Accepting new patients |
| Signify Health Medical Associates, PLLC | Multi-Specialty | Current | Accepting new patients |
| T & G Health LLC | Multi-Specialty | Past | Accepting new patients |
| Carolina Cape Fear Medical Group, PA | Multi-Specialty | Past | Accepting new patients |
| Healthsouth Men'S Clinic | Multi-Specialty | Past | Accepting new patients |
| Theoria Medical | Multi-Specialty | Past | Accepting new patients |
Locations
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
1987 Hilton Rd
Burlington, NC 27217
Phone (336) 226-0848
430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116
160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288
555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
1627 N Grand Ave
Spc Of
Gainesville, TX 76240
Phone (940) 668-6878
1902 Hospital Blvd
Gainesville, TX 76240
Phone (940) 612-8750
Interoperability endpoints
- keynaudenze@rgu.medalliesdirect.net
- kudenze@landmarkhealth-direct.org
- keynadomnicia.udenze.1@26154.direct.athenahealth.com
Organizations & group practices 12
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.
-
- General Acute Care Hospital
- Pine Ridge, SD
- NPI 1497786412
TX
-
- Rural Health Clinic/Center
- Gainesville, TX
- NPI 1033687900
Multi-Specialty
-
- General Practice Physician
- Dallas, TX
- NPI 1750845863
Multi-Specialty, NC
-
- Internal Medicine Physician
- Roanoke, VA
- NPI 1407117625
Multi-Specialty, NC
-
- Adult Medicine Physician
- Charlotte, NC
- NPI 1891649190
-
- General Practice Physician
- Gainesville, TX
- NPI 1942778816
Multi-Specialty
-
- Cardiovascular Disease Physician
- Fayetteville, NC
- NPI 1124450572
Multi-Specialty
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pine Ridge, SD
- NPI 1497786412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1679923635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 BENSON ROAD",
"address_2": "SUITE 115",
"city": "GARNER",
"state": "NC",
"postal_code": "275290016",
"telephone_number": "214-727-8681",
"fax_number": "984-246-2005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 BENSON RD STE 115",
"city": "GARNER",
"state": "NC",
"postal_code": "275293947",
"telephone_number": "984-246-2006",
"fax_number": "984-246-2005"
}
],
"practiceLocations": [
{
"address_1": "5 Firstvillage drive",
"address_purpose": "LOCATION",
"city": "Pinehurst",
"state": "NC",
"postal_code": "28374",
"country_code": "US",
"telephone_number": "910-215-2520",
"fax_number": "910-295-0244",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3637 Cape Center Dr",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283044457",
"country_code": "US",
"telephone_number": "910-491-1760",
"fax_number": "910-491-1764",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UDENZE",
"first_name": "KEYNADOMNICIA",
"middle_name": "CHIOMA",
"name_prefix": "Mrs.",
"credential": "AGNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-20",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "AP131087",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5009687",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSE PRACTITIONER LICENSE",
"identifier": "AP131087",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garner, NC
- Stephanie M Turner, M.A., LCMHC
- Steven Howard Turner, M.D.
- Schinece Turrentine, PBT, ASCP
- Pragalbha Tyagi
- U First Unidos Home Care
- Chukwuma Ukata, D.P.M.
- Unc Physicians Network Group Practices, LLC
- Unc Physicians Network Group Practices, LLC
- Unc Physicians Network Group Practices, LLC
- Unc Physicians Network, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.