Vivanchi Radiant Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

VIVANCHI RADIANT HEALTH LLC

Practice address

1733 Springfield Ave
Maplewood, NJ 07040-2963

Phone

(732) 474-6655

Fax

(732) 873-2733

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Vivian NwankwoNPI 1700269842

Title

Owner/ Apn

Phone

(732) 474-6655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vivian Nwankwo

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerset, NJ
  • NPI 1700269842
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1265251938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RIEDER CT",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732816",
            "telephone_number": "732-474-6655",
            "fax_number": "732-873-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402963",
            "telephone_number": "732-474-6655",
            "fax_number": "732-873-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVANCHI RADIANT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "OWNER/ APN",
        "authorized_official_telephone_number": "732-474-6655"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Rene Van Ness, CRC, LMHC
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• Psychiatric/Mental Health Nurse Practitioner in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.