Individual provider Active NPI

Geraldine Vughosu Nkwain, BSN,RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Eisenhower, GA
National Provider Identifier
1104306786
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1059119 Issued in TX
Practice address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone
(706) 787-5811
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1059119 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AC004621 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61517290 WA
Home Health Registered Nurse 163WH0200X 813031 TX

Addresses

Primary practice location

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741

Mailing address

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone (706) 787-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221212002034 MD Practitioner - Nurse Practitioner 5395114458 Reassigns benefits to 1 organization
I20250204003410 TX Practitioner - Nurse Practitioner 5395114458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

Austin, TX 78731
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
813031TXMDHome Health Registered Nurse
AP61517290WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A&D Mental Health Services LLC Psychiatric/Mental Health CurrentSince Feb 10, 2025 Accepting new patients
Lechia NP, Inc. Psychiatric/Mental Health CurrentSince Nov 15, 2022 Accepting new patients

Locations

5457 Twin Knolls Rd
Ste 300
Columbia, MD 21045
Phone (410) 696-5142

6801 McCart Ave
Ste 109
Fort Worth, TX 76133
Phone (469) 626-8195

Organizations & group practices 3

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1104306786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKWAIN",
        "first_name": "GERALDINE",
        "middle_name": "VUGHOSU",
        "credential": "BSN,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1059119",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC004621",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61517290",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "813031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eisenhower, GA

Sources for this page

Verify at the official NPI Registry.