Individual provider Active NPI

Cynthia Chinwendu Chiaku

  • Family Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1255963070
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004581 Issued in FL
Practice address
5957 Rowan Rd
New Port Richey, FL 34653-4531
Phone
(352) 518-2000
NPI assigned
Feb 10, 2020
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11004581 FL
Family Nurse Practitioner 363LF0000X APRN11004581 FL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11004581 FL

Addresses

Primary practice location

5957 Rowan Rd
New Port Richey, FL 34653-4531

Mailing address

5561 Sweet William Ter
Land O Lakes, FL 34639-2851
Phone (941) 264-5762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20201013001819 FL Practitioner - Nurse Practitioner 6305266305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11004581FLMDNurse Practitioner
APRN11004581FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Community Healthcare Group, Inc. CurrentSince Mar 6, 2023 Accepting new patients
Premier Community Healthcare Group Inc CurrentSince Mar 6, 2023 Accepting new patients

Locations

14027 5th St
Dade City, FL 33525
Phone (813) 782-6064

5957 Rowan Rd
New Port Richey, FL 34653
Phone (727) 645-4185

Organizations & group practices 2

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1255963070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5561 SWEET WILLIAM TER",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346392851",
            "telephone_number": "941-264-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 ROWAN RD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534531",
            "telephone_number": "352-518-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIAKU",
        "first_name": "CYNTHIA",
        "middle_name": "CHINWENDU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11004581",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004581",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11004581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.