Individual provider Active NPI

Nina Tegha Fombuh, FNP-BC, PMHNP-BC

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1932595147
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008198 Issued in NC
Practice address
2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone
(877) 993-4321
Fax
(860) 900-7945
NPI assigned
Apr 14, 2015
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008198 NC Primary
Family Nurse Practitioner 363LF0000X 005396 GA
Family Medicine Physician 207Q00000X 0024194942 VA
Family Medicine Physician 207Q00000X 28754 SC

Addresses

Primary practice location

2340 Spring Forest Rd
Raleigh, NC 27615-7528

Mailing address

2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone (877) 993-4321

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nfombuh413549@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20190723001772 NC Practitioner - Nurse Practitioner 1759661952 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians
M Medical NC PLLCGroup PAC ID 3870035066, 32 clinicians

Practice addresses (Care Compare)

2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone (866) 389-2727

2616 E 5TH St
Charlotte, NC 28204-4343
Phone (704) 333-5165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28754SCMDFamily Medicine Physician
0024194942VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renewed Axis Telehealth PLLC Current Accepting new patients
Anjies Home Care LLC Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 1, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Aug 21, 2025 Accepting new patients
M Medical NC PLLC CurrentSince Apr 26, 2025 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Apr 1, 2024 Accepting new patients

Locations

9722 Groffs Mill Dr
Owings Mills, MD 21117
Phone (410) 205-9255

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

2616 E 5th St
Charlotte, NC 28204
Phone (704) 333-5165

4801 Randolph Rd
Charlotte, NC 28211
Phone (704) 364-8363

9908 Couloak Dr
Ste 202
Charlotte, NC 28216
Phone (704) 801-3050

3715 Union Rd
Gastonia, NC 28056
Phone (704) 854-8202

17 Cornelia St
Lexington, NC 27292
Phone (336) 242-1349

215 S Main St
Mt Holly, NC 28120
Phone (704) 393-4808

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

Interoperability endpoints

  • Direct secure messaging: nfombuh413549@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1932595147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157528",
            "telephone_number": "877-993-4321",
            "fax_number": "860-900-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157528",
            "telephone_number": "877-993-4321",
            "fax_number": "860-900-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMBUH",
        "first_name": "NINA",
        "middle_name": "TEGHA",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008198",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "005396",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024194942",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "28754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfombuh413549@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "3715 Union Rd",
            "city": "Gastonia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280568044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.