Individual provider Active NPI

Ambrose Oyemhen Ukpebor

  • Psychiatric/Mental Health Nurse Practitioner
  • Morrisville, NC
National Provider Identifier
1790664944
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025030616 Issued in NC
Practice address
417 Durants Neck LN
Morrisville, NC 27560-5852
Phone
(339) 229-2392
NPI assigned
Sep 1, 2025
Last updated
Sep 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025030616 NC Primary

Addresses

Primary practice location

417 Durants Neck LN
Morrisville, NC 27560-5852

Mailing address

417 Durants Neck LN
Morrisville, NC 27560-5852
Phone (339) 229-2392

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
I20260121003292 NC Practitioner - Nurse Practitioner 6305323320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1100 Logger CT
Suite 101
Raleigh, NC 27609-8506

1100 Logger CT
Suite 101
Raleigh, NC 27609-8525

3204 Wiley Dr
North Myrtle Beach, SC 29582-4760

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025030616NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renewal Health & Recovery Clinic CurrentSince Nov 24, 2025 Accepting new patients
Freedom House Recovery Center, Inc. CurrentSince Jan 7, 2026 Accepting new patients

Locations

104 New Stateside Dr
Chapel Hill, NC 27516
Phone (833) 800-1505

118 New Stateside Dr
Chapel Hill, NC 27516
Phone (833) 800-1505

355 S Madison Blvd
Ste C
Roxboro, NC 27573
Phone (336) 599-8366

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1790664944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 DURANTS NECK LN",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605852",
            "telephone_number": "339-229-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 DURANTS NECK LN",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605852",
            "telephone_number": "339-229-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKPEBOR",
        "first_name": "AMBROSE",
        "middle_name": "OYEMHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-01",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "2025030616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

Verify at the official NPI Registry.