Individual provider Active NPI

Nelly O Wolugboms, FNP-BC

  • Family Nurse Practitioner
  • Madison, TN
National Provider Identifier
1073807632
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN0000015556 Issued in TN
Practice address
601 W Due West Ave
Madison, TN 37115-4423
Phone
(615) 227-3000
NPI assigned
Jun 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN0000015556 TN Primary

Addresses

Primary practice location

601 W Due West Ave
Madison, TN 37115-4423

Mailing address

2711 Foster Ave
Nashville, TN 37210-5307
Phone (615) 620-8647

Other names 1

  • Ms. Nelly Oghosomi Itsuoko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110621000386 TN Practitioner - Nurse Practitioner 8527246693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Neighborhood Health Services, IncGroup PAC ID 0042100091, 31 clinicians

Practice addresses (Care Compare)

601 W Due W Ave
Madison, TN 37115-4423
Phone (615) 227-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN0000015556TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Neighborhood Health Services, Inc Current Accepting new patients
United Neighborhood Health Services, Inc. CurrentSince Jul 16, 2012 Accepting new patients
United Neighborhood Health Services, Inc. CurrentSince Jul 16, 2012 Accepting new patients
United Neighborhood Health Services, Inc Past Accepting new patients
United Neighborhood Health Services, Inc Past Accepting new patients

Locations

100 Damascus St
Hartsville, TN 37074
Phone 6152273000 ext. 1880

217 E High St
Ste 200
Lebanon, TN 37087

601 W Due West Ave
Madison, TN 37115
Phone (615) 335-5194

1223 Dickerson Pike
Nashville, TN 37207
Phone (615) 983-4150

2711 Foster Ave
Nashville, TN 37210
Phone (615) 620-8647

617 S 8th St
Nashville, TN 37206
Phone (615) 226-1695

639 Lafayette St
Nashville, TN 37203
Phone (615) 228-8902

Interoperability endpoints

  • Direct secure messaging: nwolugboms@direct.neighborhoodhealthtn.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1073807632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 FOSTER AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372105307",
            "telephone_number": "615-620-8647",
            "fax_number": "615-515-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W DUE WEST AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154423",
            "telephone_number": "615-227-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLUGBOMS",
        "first_name": "NELLY",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APRN0000015556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NELLY",
            "last_name": "ITSUOKO",
            "middle_name": "OGHOSOMI",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, TN

Sources for this page

Verify at the official NPI Registry.