Individual provider Active NPI

Josiah Nnadozie Nwaokwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1053854638
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
TAP 9692 Issued in AZ
Practice address
1095 E Indian School Rd Ste 700
Phoenix, AZ 85014-4846
Phone
(623) 225-7591
Fax
(623) 230-3726
NPI assigned
Nov 30, 2016
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 TAP 9692 AZ Primary

Addresses

Primary practice location

1095 E Indian School Rd Ste 700
Phoenix, AZ 85014-4846

Mailing address

1095 E Indian School Rd Ste 700
Phoenix, AZ 85014-4846
Phone (623) 225-7591

Other identifiers 1

IdentifierTypeStateIssuer
223013MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20171208000766 AZ Practitioner - Nurse Practitioner 0941567408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1095 E Indian School Rd
Suite 700
Phoenix, AZ 85014-4846
Phone (623) 225-7591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAP 9692AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Zenhealth PLLC Psychiatric/Mental Health CurrentSince Oct 9, 2018 Accepting new patients

Locations

1095 E Indian School Rd
Ste 700
Phoenix, AZ 85014
Phone (602) 515-9893

5251 W Campbell Ave
Ste 208
Phoenix, AZ 85031
Phone (347) 848-2576

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": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1053854638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 E INDIAN SCHOOL RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850144846",
            "telephone_number": "623-225-7591",
            "fax_number": "623-230-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 E INDIAN SCHOOL RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850144846",
            "telephone_number": "623-225-7591",
            "fax_number": "623-230-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAOKWA",
        "first_name": "JOSIAH",
        "middle_name": "NNADOZIE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-30",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "TAP 9692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223013",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.