Individual provider Active NPI

Chiamaka Perditta Nwankiti, M.B.B.S, M.P.H

  • Child & Adolescent Psychiatry Physician
  • Minneapolis, MN
National Provider Identifier
1437566437
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
63333 Issued in MN
Practice address
2450 Riverside Ave South
Minneapolis, MN 55455
Phone
(612) 273-9824
NPI assigned
Jul 22, 2014
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Child & Adolescent Psychiatry Physician 2084P0804X 63333 MN Primary

Addresses

Primary practice location

2450 Riverside Ave South
Minneapolis, MN 55455

Mailing address

2450 Riverside Ave South
Minneapolis, MN 55455
Phone (612) 273-9824

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190711003600 MN Practitioner - Psychiatry 2961794631 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63333MNMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Oct 20, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Oct 20, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Oct 20, 2022 Accepting new patients
Fairview Health Services CurrentSince Jul 31, 2019 Accepting new patients
Fairview Express Care CurrentSince Jul 31, 2019 Accepting new patients
Fairview Express Care CurrentSince Sep 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Sep 1, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Oct 20, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2450 Riverside Ave
#F282
Minneapolis, MN 55454

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

5775 Wayzata Blvd
Ste 255
St Louis Park, MN 55416
Phone (612) 273-8710

Interoperability endpoints

  • Direct secure messaging: cnwankiti318948@fairview.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1437566437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANKITI",
        "first_name": "CHIAMAKA",
        "middle_name": "PERDITTA",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S, M.P.H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "63333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.