Individual provider Active NPI

Aniekan Udoh, APRN, PMHNP- BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1164903399
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1172829 Issued in TX
Practice address
600 1St Ave
Suite 102 #2096
Seattle, WA 98104-2287
Phone
(832) 433-0465
NPI assigned
Aug 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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 1172829 TX Primary

Addresses

Primary practice location

600 1St Ave
Suite 102 #2096
Seattle, WA 98104-2287

Mailing address

600 1St Ave
Suite 102 #2096
Seattle, WA 98104-2287
Phone (281) 846-5587

Other practice location 1

1720 E Boston St
Gilbert, AZ 85295-6226
Phone (281) 846-5587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO, WA, CA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20250124000409 AZ Practitioner - Nurse Practitioner 6709315450 Reassigns benefits to 2 organizations
I20250623002383 CO Practitioner - Nurse Practitioner 6709315450 Reassigns benefits to 1 organization
I20250623002398 WA Practitioner - Nurse Practitioner 6709315450 Reassigns benefits to 1 organization
I20250820002061 CA Practitioner - Nurse Practitioner 6709315450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahodas PLLCGroup PAC ID 4789807280, 3 clinicians

Practice addresses (Care Compare)

1720 E Boston St
Gilbert, AZ 85295-6226
Phone (480) 745-3702

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1172829TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Road to Healing Psychiatric LLC CurrentSince Jun 3, 2025 Accepting new patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Jul 8, 2025 Accepting new patients
Sud Specialty Group - Ca Psychiatric/Mental Health CurrentSince Oct 1, 2025 Accepting new patients
Lahodas PLLC CurrentSince Jan 7, 2025 Accepting new patients
Bluebonnet Lifecare, LLC PastSince Aug 29, 2021 Accepting new patients

Locations

1720 E Boston St
Ste 101
Gilbert, AZ 85295

1720 E Boston St
Gilbert, AZ 85295
Phone (281) 846-5587

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

600 1st Ave
Ste 102
Seattle, WA 98104
Phone (206) 209-1390

Interoperability endpoints

  • Direct secure messaging: aniekan.udoh.1@7817.direct.athenahealth.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": "1535155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1164903399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 1ST AVE",
            "address_2": "SUITE 102 #2096",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042287",
            "telephone_number": "281-846-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 1ST AVE",
            "address_2": "SUITE 102 #2096",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042287",
            "telephone_number": "832-433-0465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 E Boston St",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852956226",
            "country_code": "US",
            "telephone_number": "281-846-5587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDOH",
        "first_name": "ANIEKAN",
        "credential": "APRN, PMHNP- BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-25",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1172829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.