Individual provider Active NPI

Nkwachioma Ugwuezi Nwosu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, NC
National Provider Identifier
1356041420
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023003081 Issued in NC
Practice address
101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone
(855) 743-2247
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 2023003081 NC Primary

Addresses

Primary practice location

101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781

Mailing address

101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone (704) 986-9855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230901000266 NC Practitioner - Nurse Practitioner 7315300795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2421 Timber Dr
Suite 207
Raleigh, NC 27604-2265
Phone (919) 741-2024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023003081NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Sep 25, 2024 Accepting new patients
Dynamic Healthcare, PLLC Psychiatric/Mental Health CurrentSince Aug 7, 2019 Accepting new patients
Eventus WH PLLC Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Eventus Wholehealth Aco LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

2421 Timber Dr
Ste 207
Raleigh, NC 27604
Phone (919) 523-4849

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1356041420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253781",
            "telephone_number": "704-986-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253781",
            "telephone_number": "855-743-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "NKWACHIOMA",
        "middle_name": "UGWUEZI",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "2023003081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.