Tisungane Blessing Chiwembu, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG06230192 Issued in AL

Practice address

3151-A Knollwood Drive
Mobile, Al 36693
Mobile, AL 36693

Phone

(251) 661-7608

Fax

(251) 602-9146

NPI assigned

Aug 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment NPD
• Dearborn Homes Inc.

  • Nurse Practitioner
  • Mobile, AL
  • NPI 1689412736
  NPD Authorized official

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1013699172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANDE OAK BLVD APT 1102",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713741",
            "telephone_number": "251-533-0642",
            "fax_number": "251-602-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151-A KNOLLWOOD DRIVE",
            "address_2": "MOBILE, AL 36693",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36693",
            "telephone_number": "251-661-7608",
            "fax_number": "251-602-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIWEMBU",
        "first_name": "TISUNGANE",
        "middle_name": "BLESSING",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "AG06230192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirosouth Spine and Sport LLC
• Emily Chisholm, PT
• Jason N Chisholm, PT
• Melissa Chisholm
• Savannah Chisom, AUD
• Dahye Choi, PH.D.
• Peter Choi
• Tyler Choi
• Christine Choquette
• Christopher Harris Choquette, CRNP

• Gerontology Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Gerontology Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.