Active NPI
Ifeoma Umelo
- Adult Mental Health Clinic/Center
- Raleigh, NC
National Provider Identifier
1790322725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- License
- MHL-092-973
- Practice address
- 1921 Waters Dr
Raleigh, NC 27610-4836 - Phone
- (919) 539-9223
- NPI assigned
- Dec 10, 2019
- Last updated
- Dec 10, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | MHL-092-973 | NC | Primary |
Addresses
Primary practice location
1921 Waters Dr
Raleigh, NC 27610-4836
Mailing address
2204 Havering PL
Raleigh, NC 27604-0801
Phone (919) 539-9223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C201919301765 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHL-092-973 | NC | MD | Adult Mental Health Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twinkle-Star Home Services LLC | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Raleigh, NC
- NPI 1467099341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1790322725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 HAVERING PL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276040801",
"telephone_number": "919-539-9223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 WATERS DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276104836",
"telephone_number": "919-539-9223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UMELO",
"first_name": "IFEOMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-10",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": "NC",
"license": "MHL-092-973",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "C201919301765",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.