Individual provider Active NPI

Ugonna Thomas Nwankwo, MD

  • Adult Congenital Heart Disease Physician
  • Saint Louis, MO
National Provider Identifier
1356661433
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Congenital Heart Disease PhysicianTaxonomy code 207RA0002X
License
2020041928 Issued in MO
Practice address
4921 Parkview PL
Div Im Cardiology, Ste 8B
Saint Louis, MO 63110-1032
Phone
(314) 362-1291
Fax
(314) 747-8213
NPI assigned
Jun 11, 2010
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2020041928 MO
Cardiovascular Disease Physician 207RC0000X 2020041928 MO
Pediatrics Physician 208000000X 2020041928 MO
Pediatric Cardiology Physician 2080P0202X 2020041928 MO
Adult Congenital Heart Disease Physician 207RA0002X 2020041928 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Div Im Cardiology, Ste 8B
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-1291

Other identifiers 1

IdentifierTypeStateIssuer
200091800MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180822003181 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 2466701545 Reassigns benefits to 2 organizations
I20210223000460 MO Practitioner - Adult Congenital Heart Disease (Achd)Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 2466701545 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Adult Congenital Heart Disease (Achd)Also: Cardiovascular Disease (Cardiology)
Education
Wake Forest University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, shared by 49 NPIs, 2,968 clinicians

Practice addresses (Care Compare)

1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 273-1006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Care Institute LLC CurrentSince Jun 9, 2025 Accepting new patients
Washington University CurrentSince Jun 9, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Heart Care Institute LLC CurrentSince Jun 9, 2025 Accepting new patients
Washington University CurrentSince Jun 9, 2025 Accepting new patients
Washington University CurrentSince Jun 9, 2025 Accepting new patients
Washington University Past Accepting new patients
SSM Cardinal Glennon Children's Hospital Past Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

1020 N Mason Rd
Ste 210
Saint Louis, MO 63141
Phone (314) 996-3162

1234 S Kingshighway Blvd
Ste 1100
Saint Louis, MO 63110

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

4921 Parkview Pl
Ste 8B
Saint Louis, MO 63110
Phone (314) 454-8917

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1356661433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-1291",
            "fax_number": "314-747-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV IM CARDIOLOGY, STE 8B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-1291",
            "fax_number": "314-747-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANKWO",
        "first_name": "UGONNA",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2025-06-20",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020041928",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2020041928",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2020041928",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2020041928",
            "primary": false
        },
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "MO",
            "license": "2020041928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200091800",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div IM Cardiology, Ste 8B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.