Individual provider Active NPI

Ogechukwu Ugwu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1023777570
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8842 Issued in MN
Practice address
2658 Brittany LN
Woodbury, MN 55125-3017
Phone
(651) 795-9209
NPI assigned
Dec 13, 2021
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8842 MN Primary

Addresses

Primary practice location

2658 Brittany LN
Woodbury, MN 55125-3017

Mailing address

2658 Brittany LN
Woodbury, MN 55125-3017
Phone (651) 795-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220321002148 MN Practitioner - Certified Clinical Nurse Specialist (CNS) 7911392345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8842MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 2

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": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1023777570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 BRITTANY LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253017",
            "telephone_number": "651-795-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2658 BRITTANY LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253017",
            "telephone_number": "651-795-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGWU",
        "first_name": "OGECHUKWU",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.