Individual provider Active NPI

Chidiogo Carole Nwokike

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1184114522
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN002910 Issued in NV
Practice address
500 N Rainbow Blvd
Las Vegas, NV 89107-1082
Phone
(702) 514-4057
Fax
(888) 984-4620
NPI assigned
May 11, 2018
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95014548 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN002910 NV Primary

Addresses

Primary practice location

500 N Rainbow Blvd
Las Vegas, NV 89107-1082

Mailing address

10141 Rockridge Peak Ave
Las Vegas, NV 89166-5200

Other practice location 1

1340 Tully Rd Ste 301&304
San Jose, CA 95122
Phone (800) 704-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 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
I20180817001099 NV Practitioner - Nurse Practitioner 2466701834 Reassigns benefits to 3 organizations
I20221110001732 CA Practitioner - Nurse Practitioner 2466701834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

626 N Rainbow Blvd
Las Vegas, NV 89107-1101
Phone (702) 778-7782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014548CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Exceeding Healthcare Services Psychiatric/Mental Health CurrentSince Jul 20, 2020 Accepting new patients
Healthright 360 CurrentSince Jul 30, 2022 Accepting new patients
Behavioral Health Solutions LLC CurrentSince Apr 2, 2020 Accepting new patients
Healthright 360 CurrentSince Jul 30, 2022 Accepting new patients
Healthright 360 Current Accepting new patients
Next Level Psychiatry Arizona PLLC CurrentSince Apr 2, 2020 Accepting new patients
Paramount Healthcare Services Corp Psychiatric/Mental Health CurrentSince Feb 4, 2020 Accepting new patients
Peace of Mind Home Health Agency LLC PastSince Feb 4, 2020 Accepting new patients
Maria K Nwokikemd Face PC PastSince Jul 1, 2018 Accepting new patients

Locations

1340 Tully Rd
Ste 301
San Jose, CA 95122
Phone (408) 505-5575

2200 Paseo Verde Pkwy
Ste 190
Henderson, NV 89052
Phone (702) 483-5061

500 N Rainbow Blvd
Ste 300
Las Vegas, NV 89107
Phone (702) 389-1148

626 N Rainbow Blvd
Las Vegas, NV 89107
Phone (702) 778-7782

Interoperability endpoints

  • Direct secure messaging: chidiogo.nwokike.1@24259.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Peace of Mind Home Health Agency LLCLas Vegas, NV, CCN 297325 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Director (50%)
W-2 Managing Employee (100%)
Aug 6, 2018
Aug 6, 2018
Aug 6, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1184114522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10141 ROCKRIDGE PEAK AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891665200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071082",
            "telephone_number": "702-514-4057",
            "fax_number": "888-984-4620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Tully Rd Ste 301&304",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "95122",
            "country_code": "US",
            "telephone_number": "800-704-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWOKIKE",
        "first_name": "CHIDIOGO",
        "middle_name": "CAROLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95014548",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN002910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.