NPIMap

Individual provider Active NPI

Ajikele Nwankwo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Alvin, TX
National Provider Identifier
1205409042
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1032178 Issued in TX
Practice address
1111 W Adoue St
Alvin, TX 77511-2718
Phone
(281) 824-1480
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 1032178 TX
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 1032178 TX Primary

Addresses

Primary practice location

1111 W Adoue St
Alvin, TX 77511-2718

Mailing address

412 Cedar Lake Dr
League City, TX 77573-0884
Phone (972) 781-8659

Other practice location 1

8030 Fm 1765 Ste C-102
Texas City, TX 77591-3689
Phone (972) 781-8659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419001026 TX Practitioner - Nurse Practitioner 8022403252 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen F Austin Community Health Center, Inc.Group PAC ID 6204977127, 95 clinicians

Practice addresses (Care Compare)

1111 W Adoue St
Alvin, TX 77511-2718
Phone 28182414801594

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gob Behavioral Health PLLC Multi-Specialty CurrentSince Feb 1, 2022 Accepting new patients
Lago Mar Medical Clinic LLC Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Stephen F. Austin Community Health Center, Inc. Multi-Specialty CurrentSince Nov 16, 2022 Accepting new patients
Govicare LLC Multi-Specialty CurrentSince Oct 13, 2025 Accepting new patients
Stephen F Austin Community Health Center,Inc Multi-Specialty CurrentSince Nov 16, 2022 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

1350 Nasa Pkwy
Ste 203
Houston, TX 77058
Phone (281) 694-4758

2360 Gulf Fwy S
#100C
League City, TX 77573

8030 FM 1765
Ste C102
Texas City, TX 77591
Phone (409) 515-3915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25264/brand/1/csg/1/fhir/r4

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1205409042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CEDAR LAKE DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775730884",
            "telephone_number": "972-781-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8030 Fm 1765 Ste C-102",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "775913689",
            "country_code": "US",
            "telephone_number": "972-781-8659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWANKWO",
        "first_name": "AJIKELE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1032178",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1032178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alvin, TX

Sources for this page

Verify at the official NPI Registry.