Kyong Chang Power
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Godwin, NC
NPI 1841990231 · NPPES record last updated Dec 7, 2023
Key facts
- NPI
- 1841990231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 5018451 (NC)
- Practice address
- 6116 Percy Strickland Rd
Godwin, NC 28344-8476 - Phone
- (910) 705-2483
- NPI assigned
- Mar 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Eventus Wholehealth PLLC
Eventus WH Southeast, LLC
Practice addresses (Care Compare)
101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247
212 S Tryon St
Suite 1000
Charlotte, NC 28281-0006
Phone (855) 743-2247
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830000444 | NC | Practitioner - Nurse Practitioner | 6901269588 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POWE-5291Z | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Wholehealth, PLLC | Psychiatry | Current |
Accepting new patients |
| Eventus Wholehealth Aco LLC | Current |
Accepting new patients | |
| Eventus WH PLLC Care, LLC | Current |
Accepting new patients | |
| Eventus WH Southeast, LLC | Current |
Accepting new patients | |
| Eventus Value Care, LLC | Current |
Accepting new patients |
Locations
2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217
212 S Tryon St
Ste 1000
Charlotte, NC 28281
Phone (512) 575-8028
160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | POWE-5291Z | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5018451 | NC | Yes |
Addresses
Primary practice location
6116 Percy Strickland Rd
Godwin, NC 28344-8476
Mailing address
6116 Percy Strickland Rd
Godwin, NC 28344-8476
Phone (910) 705-2483
Other providers in Godwin, NC
- GHSD Inc. (Dba) Agape Group Homes
- Jill F Holland
- Crystal Melvin
- Dawn Angelina Nogal
- Patricia Owens Page
- Rhonda Moore Sweitzer
- Patterson Williams
All providers in Godwin, NC · Psychiatric/Mental Health Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.