Individual provider Active NPI

Chisomnazu Winifred Iweha-Ononye, NP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1083978274
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4314 Issued in AZ
Practice address
6601 West Thomas Road
Phoenix, AZ 85033
Phone
(602) 243-7277
Fax
(623) 247-9742
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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 AP4314 AZ Primary

Addresses

Primary practice location

6601 West Thomas Road
Phoenix, AZ 85033

Mailing address

2702 North 3Rd Street
4020
Phoenix, AZ 85004
Phone (602) 323-3407

Other identifiers 1

IdentifierTypeStateIssuer
715482MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4314AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Past Accepting new patients
Mountain Park Health Center - Dental Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1083978274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NORTH 3RD STREET",
            "address_2": "4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85004",
            "telephone_number": "602-323-3407",
            "fax_number": "602-323-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 WEST THOMAS ROAD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85033",
            "telephone_number": "602-243-7277",
            "fax_number": "623-247-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWEHA-ONONYE",
        "first_name": "CHISOMNAZU",
        "middle_name": "WINIFRED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715482",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.