Agyare Antwi, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202205309NP-PP Issued in OR

Practice address

17339 Heath Grove LN
Richmond, TX 77407-8027

Phone

(574) 217-2408

NPI assigned

Mar 16, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHS Office of Financial Services Irs Eopc BMRC Eotc Osh Osh-PGroup PAC ID 0547170383, 45 clinicians

Amber Benson Pmhnp PCGroup PAC ID 3072786755, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Amber Benson Pmhnp PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1912042862

  Single Specialty

  Medicare reassignment Care Compare group NPD
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314

  Single Specialty

  Medicare reassignment NPD
• Restore Care, Inc.

  • In Home Supportive Care Agency
  • Katy, TX
  • NPI 1861090011
  NPD Authorized official
• 1St State Healthcare, Inc.

  • Home Health Agency
  • Houston, TX
  • NPI 1942473624
  NPD (past)
• Resource Health Care, Inc.

  • Home Health Agency
  • Houston, TX
  • NPI 1396843066
  NPD (past)
• South Lane Mental Health Services, Inc

  • Community/Behavioral Health Agency
  • Cottage Grove, OR
  • NPI 1306905831

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1245988484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17339 HEATH GROVE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774078027",
            "telephone_number": "574-217-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17339 HEATH GROVE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774078027",
            "telephone_number": "574-217-2408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Club Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974012439",
            "country_code": "US",
            "telephone_number": "541-345-1722",
            "fax_number": "541-485-7049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1245 Birch Ave",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "OR",
            "postal_code": "974241413",
            "country_code": "US",
            "telephone_number": "541-942-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "955 Coburg Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974016426",
            "country_code": "US",
            "telephone_number": "541-345-1722",
            "fax_number": "541-485-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTWI",
        "first_name": "AGYARE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-16",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202205300RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1068282",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202205309NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "15535934",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500810911",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zeenia Ansari, O.D.
• Kwadwo K Ansong, PHARM.D.,BCPS,BCGP,
• Anthony Obinzu and Francis Obinzu
• Anthony Obinzu and Francis Obinzu
• Breeanna Mayo Antuzzi
• George Antwi, PHARMD
• Ndidiamaka Glory Anugo
• Paula C Anugo, BCBA
• Uduak Anwanane
• Chioma Adamaka Anyadike, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Richmond, TX
• Providers in Richmond, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.