Clementina Nkiru Okorji, MSN, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SPO18410 Issued in PA

Practice address

857 Montgomery Ave
Penn Valley, PA 19072-1541

Phone

(610) 664-2951

NPI assigned

Apr 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line Medical Group LTDGroup PAC ID 9830003599, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Main Line Medical Group LTD

  • Family Medicine Physician
  • Narberth, PA
  • NPI 1760415913
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1396241568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 CHELSEA CT",
            "city": "HATFIELD",
            "state": "PA",
            "postal_code": "194404115",
            "telephone_number": "267-235-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 MONTGOMERY AVE",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190721541",
            "telephone_number": "610-664-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORJI",
        "first_name": "CLEMENTINA",
        "middle_name": "NKIRU",
        "credential": "MSN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SPO18410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "27828572",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MB Dentist Inc
• Bridget Anne McElroy
• Stephanie A McKnight, M.D.
• Aleksandra Meyerson, DPT
• Ngozi-Chukwu Nduka
• Penn Valley Urgent Care
• Elizabeth Poinsett
• Jordana Faith Popovich, CRNP
• Julie Beth Portnoy, M.A.
• Frederick Clemens Pratt, LPC

• Gerontology Nurse Practitioner in Penn Valley, PA
• Providers in Penn Valley, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.