Individual provider Active NPI

Ugonna Duru

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1205425386
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95021659 Issued in CA
Practice address
12610 Henderson Rd
Tampa, FL 33625-6548
Phone
(813) 592-8958
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 11007975 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95021659 CA Primary
Registered Nurse 163W00000X 11007975 FL
Family Nurse Practitioner 363LF0000X 11007975 FL

Addresses

Primary practice location

12610 Henderson Rd
Tampa, FL 33625-6548

Mailing address

12610 Henderson Rd
Tampa, FL 33625-6548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WA, NY, CA, CO, NM, AZ7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20231023000797 FL Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 2 organizations
I20240516002616 WA Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 2 organizations
I20250911004813 NY Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 1 organization
I20250919001771 CA Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 1 organization
I20250919002141 CO Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 1 organization
I20251107000487 NM Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 1 organization
I20251112002640 AZ Practitioner - Nurse Practitioner 6507212974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11007975FLMDFamily Nurse Practitioner
NP95021659CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Aug 8, 2025 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

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

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

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

500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1205425386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12610 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336256548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336256548",
            "telephone_number": "813-592-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURU",
        "first_name": "UGONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11007975",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95021659",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "11007975",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.