Organization Active NPI

Reagan Obiozor Anusionwu NP Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1275905994
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401556 Issued in NY
Legal business name
REAGAN OBIOZOR ANUSIONWU NP PSYCHIATRY PLLC
Practice address
548 Throgs Neck Expwy
Bronx, NY 10465
Phone
(646) 798-7924
Fax
(347) 287-6916
NPI assigned
Oct 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Reagan AnusionwuNPI 1346492105
Title
Sole Proprietor
Phone
(646) 798-7924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 401556 NY Primary

Addresses

Primary practice location

548 Throgs Neck Expwy
Bronx, NY 10465

Mailing address

22716 67TH Ave.
Oakland Gardens, NY 11364
Phone (646) 798-7924

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241202000597 NY Part B Supplier - Clinic/Group Practice 5991230831 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

548 Throggs Neck Expy
Bronx, NY 10465
Phone (800) 632-7969

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1275905994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22716 67TH AVE.",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "646-798-7924",
            "fax_number": "347-287-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 THROGS NECK EXPWY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10465",
            "telephone_number": "646-798-7924",
            "fax_number": "347-287-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAGAN OBIOZOR ANUSIONWU NP PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "ANUSIONWU",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "646-798-7924"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.