MEDICARE: MS. ADIYAH USSERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		NC

General Provider Information

NPI Number	:	1841140472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADIYAH USSERY

Provider Business Mailing Address
First Line	:	1329 BRIAR CREEK RD APT 8
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-8219
Country	:	US
Telephone Number	:
Fax Number	:	828-788-2696

Provider Business Practice Location Address
First Line	:	1329 BRIAR CREEK RD APT 8
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-8219
Country	:	US
Telephone Number	:	828-788-2696
Fax Number	:	828-788-2696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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