Restored Mind Psychiatric Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RESTORED MIND PSYCHIATRIC SERVICES

Practice address

500 N Rainbow Blvd Ste 300
Las Vegas, NV 89107-1061

Phone

(702) 508-6608

Fax

(702) 508-6643

NPI assigned

Apr 20, 2021

Organization subpart

No

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

Authorized official

Name

Ugoezi Bridget Agu, DNPNPI 1467406868

Title

Nurse Practitioner

Phone

(702) 964-2122

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ugoezi Bridget Agu

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1467406868
  Medicare reassignment Care Compare group NPD Authorized official
• Nicole C Okeke, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1164752879
  Medicare reassignment Care Compare group NPD
• Ajumobi Charles Agu, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1336453927
  NPD (past)

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1194306274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071061",
            "telephone_number": "702-508-6608",
            "fax_number": "702-508-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071061",
            "telephone_number": "702-508-6608",
            "fax_number": "702-508-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORED MIND PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "AGU",
        "authorized_official_first_name": "UGOEZI",
        "authorized_official_middle_name": "BRIDGET",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "702-964-2122",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "restoredmindnv@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business Gmail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 N Rainbow Blvd Ste 300",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891071061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "restoredmindnv@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business gmail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 N Rainbow Blvd Ste 300",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891071061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Restoration Wellness Center, LLC
• Restorative Medicine LLC
• Restorative Wellness LLC
• Restore Care Center Corp
• Restore Family Care, LLC
• Sarah Jane Restori
• Restoring Lives LLC
• Restoring the Mind
• Restorix
• Humberto Restrepo, OMD

• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.