Kofi Asiedu, NP

Key facts

NPI

1912374166

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

5007858 (NC)

Practice address

10406 Cullen CT
Charlotte, NC 28278-8024

Phone

(704) 858-0660

NPI assigned

Aug 24, 2015

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Caromont Medical Group Inc Family Medicine Physician · Gastonia, NC · NPI 1356314272
  Medicare reassignment Care Compare group NPD NC
• Caromont Medical Group Inc Family Medicine Physician · Clover, SC · NPI 1568641165
  Medicare reassignment Care Compare group NPD SC
• Dr. Shiranee Jayasooriya Inc Physical Medicine & Rehabilitation Physician · Las Vegas, NV · NPI 1225067408
  Medicare reassignment NPD SC
• Gabbysco Home Care Agency, LLC In Home Supportive Care Agency · Waxhaw, NC · NPI 1669096855
  NPD Authorized official
• Caromont Medical Group, Inc. Family Medicine Physician · Lake Wylie, SC · NPI 1609467760
  NPD

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gaston Memorial Hospital, Incorporated General Acute Care Hospital · Gastonia, NC · NPI 1013918960
  Care Compare affiliation Hospital
• Encompass Health Rehabilitation Hospital of Rock Hill, LLC Rehabilitation Hospital · Rock Hill, SC · NPI 1184697807
  Care Compare affiliation Inpatient rehabilitation facility

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group Inc (425 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caromont Regional Medical Center Hospital · Gastonia, NC · CCN 340032
• Encompass Health Rehabilitation Hospital of Rock H Inpatient rehabilitation facility · Rock Hill, SC · CCN 423028

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in SC, NC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 24, 2015.

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1912374166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10406 CULLEN CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282788024",
            "telephone_number": "704-858-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10406 CULLEN CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282788024",
            "telephone_number": "704-858-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIEDU",
        "first_name": "KOFI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Charlotte, NC · Family Nurse Practitioner in North Carolina