Ifedima Nwankwo, LAT, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE013262 Issued in PA

Practice address

660 Boas St Apt 1209
Harrisburg, PA 17102-1313

Phone

(202) 802-2552

NPI assigned

Sep 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1073062287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BOAS ST APT 1209",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BOAS ST APT 1209",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021313",
            "telephone_number": "202-802-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANKWO",
        "first_name": "IFEDIMA",
        "credential": "LAT, ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000891",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE013262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Nunez, LCSW
• Nurturing Place Homecare
• Sean Philip Nutting, MD
• Chinenye P Nwachukwu, PMHNP-BC
• Sarai Nwagbaraocha, DO
• Mary Nyaaba
• Shelbie Nyman, BCBA/LBS
• Akuol Nyuol
• Lisa Kathleen O'Brien, D.O.
• Brent James O'Connell, M.D.

• Physical Therapy Assistant in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.