Individual provider Active NPI

Chukwudi Victor Okolie, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1295502060
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ14971100 Issued in NJ
Practice address
3020 S Union Ave
Tacoma, WA 98409-3317
Phone
(253) 844-4327
NPI assigned
Dec 11, 2023
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 26NJ14971100 NJ Primary

Addresses

Primary practice location

3020 S Union Ave
Tacoma, WA 98409-3317

Mailing address

917 Pacific Ave Ste 600
Tacoma, WA 98402-4437
Phone (253) 844-4327

Other practice location 1

Hudson County Correctional Center
30 Hackensack Avenue
Kearny, NJ 07032
Phone (201) 395-5600 ext. 5059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, WA2 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
I20240313001893 NJ Practitioner - Nurse Practitioner 4587000500 Reassigns benefits to 1 organization
I20250610003480 WA Practitioner - Nurse Practitioner 4587000500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Peaks Healthcare PCGroup PAC ID 0648784157, 45 clinicians
Pacific Medical Specialty GroupGroup PAC ID 2365838364, 56 clinicians

Practice addresses (Care Compare)

3020 S Union Ave
Tacoma, WA 98409-3317
Phone (253) 844-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Medical Dialysis Services CurrentSince Jun 1, 2025 Accepting new patients
NJ Memory and Behavioral Care CurrentSince Jan 29, 2024 Accepting new patients
Pacific Medical Specialty Group CurrentSince Apr 28, 2025 Accepting new patients
Platinum Peaks Healthcare PC CurrentSince Aug 18, 2025 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

575 Route 28
Bldg 2
Raritan, NJ 08869
Phone (973) 295-6335

3020 S Union Ave
Tacoma, WA 98409
Phone (253) 844-4327

917 Pacific Ave
Ste 100
Tacoma, WA 98402
Phone (253) 670-3099

917 Pacific Ave
Ste 600
Tacoma, WA 98402
Phone (253) 232-7495

Organizations & group practices 4

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": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1295502060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 PACIFIC AVE STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024437",
            "telephone_number": "253-844-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984093317",
            "telephone_number": "253-844-4327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hudson County Correctional Center",
            "address_2": "30 Hackensack Avenue",
            "address_purpose": "LOCATION",
            "city": "Kearny",
            "state": "NJ",
            "postal_code": "07032",
            "country_code": "US",
            "telephone_number": "201-395-5600 x5059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKOLIE",
        "first_name": "CHUKWUDI",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14971100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.