Individual provider Active NPI

Louisa Ugochukwu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1306694369
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1159667 Issued in TX
Practice address
906 W Cannon St Apt 100
Fort Worth, TX 76104-3052
Phone
(817) 886-4976
Fax
(866) 428-6674
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 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 1159667 TX Primary

Addresses

Primary practice location

906 W Cannon St Apt 100
Fort Worth, TX 76104-3052

Mailing address

906 W Cannon St Apt 100
Fort Worth, TX 76104-3052
Phone (817) 672-8602

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1159667TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vigeo Ketamine and Wellness Center, LLC CurrentSince Sep 8, 2024 Accepting new patients

Locations

906 W Cannon St
Apt 100
Fort Worth, TX 76104
Phone (817) 634-5521

1800 Lone Oak Rd
Ste 10
Weatherford, TX 76086
Phone (817) 672-9407

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1306694369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W CANNON ST APT 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043052",
            "telephone_number": "817-672-8602",
            "fax_number": "817-345-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W CANNON ST APT 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043052",
            "telephone_number": "817-886-4976",
            "fax_number": "866-428-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGOCHUKWU",
        "first_name": "LOUISA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1159667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.