Individual provider Active NPI

Victor Toochukwu Nwagwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Colonial Heights, VA
National Provider Identifier
1215637863
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024186638 Issued in VA
Practice address
3611 Boulevard
Colonial Heights, VA 23834-1344
Phone
(804) 372-5476
Fax
(804) 509-0531
NPI assigned
Mar 2, 2023
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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 0024186638 VA Primary

Addresses

Primary practice location

3611 Boulevard
Colonial Heights, VA 23834-1344

Mailing address

3611 Boulevard
Colonial Heights, VA 23834-1344
Phone (804) 372-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20230510000406 VA Practitioner - Nurse Practitioner 2163897422 Reassigns benefits to 3 organizations
I20230623002816 DC Practitioner - Nurse Practitioner 2163897422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3611 Boulevard
Colonial Heights, VA 23834-1344
Phone (804) 372-5476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024186638VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flabwell Health Group LLC Psychiatric/Mental Health CurrentSince Nov 5, 2023 Accepting new patients
Psychogeriatric Services LLC CurrentSince May 23, 2023 Accepting new patients
Elgreat Healthcare Services LLC Psychiatric/Mental Health CurrentSince May 1, 2023 Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

3611 Boulevard
Colonial Hgts, VA 23834
Phone (804) 526-2816

2301 Hilliard Rd
Ste 4
Henrico, VA 23228
Phone (804) 528-9752

8575 Rixlew Ln
Manassas, VA 20109
Phone (703) 257-9770

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, 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": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1215637863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341344",
            "telephone_number": "804-372-5476",
            "fax_number": "804-509-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341344",
            "telephone_number": "804-372-5476",
            "fax_number": "804-509-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAGWU",
        "first_name": "VICTOR",
        "middle_name": "TOOCHUKWU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.