Individual provider Active NPI

Chinonyelum Nwokedi

  • Speech-Language Pathologist
  • Beaver, PA
National Provider Identifier
1306181623
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
110935 Issued in TX
Practice address
310 Wayne St
Beaver, PA 15009
Phone
(724) 774-2677
Fax
(724) 774-0821
NPI assigned
Nov 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL011184 PA
Speech-Language Pathologist 235Z00000X 110935 TX Primary

Addresses

Primary practice location

310 Wayne St
Beaver, PA 15009

Mailing address

8877 Frankway Dr Apt 1126
Houston, TX 77096-1913
Phone (412) 360-9493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SL011184PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospera Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 10, 2024 Accepting new patients

Locations

16700 Ella Blvd
Houston, TX 77090
Phone (281) 215-5985

22720 Morton Ranch Rd
Ste 160
Katy, TX 77449
Phone (409) 292-7685

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1306181623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8877 FRANKWAY DR APT 1126",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770961913",
            "telephone_number": "412-360-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 WAYNE ST",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "15009",
            "telephone_number": "724-774-2677",
            "fax_number": "724-774-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOKEDI",
        "first_name": "CHINONYELUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL011184",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.