Individual provider Active NPI

Louismarie Bernadine Nnanabu Sr.

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1447710553
Registry record updated Mar 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00902200 Issued in NJ
Practice address
522 Orange St
Newark, NJ 07107-2161
Phone
(201) 463-2684
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2019

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 26NJ00902200 NJ Primary

Addresses

Primary practice location

522 Orange St
Newark, NJ 07107-2161

Mailing address

522 Orange St
Newark, NJ 07107-2161
Phone (201) 463-2684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20191014000732 NJ Practitioner - Nurse Practitioner 2769713379 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00902200NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True Care Mental Health Clinic LLC CurrentSince Feb 1, 2021 Accepting new patients
Mater Dei Behavioral Consult LLC Psychiatric/Mental Health CurrentSince Mar 3, 2026 Accepting new patients
MMM Health Services CurrentSince Jan 1, 2025 Accepting new patients
Newark Community Health Centers, Inc. CurrentSince Jan 1, 2023 Accepting new patients
All Health Services PC CurrentSince Aug 26, 2023 Accepting new patients
Newark Community Health Centers, Inc CurrentSince Jan 1, 2023 Accepting new patients
L&a Absolute Care LLC Psychiatric/Mental Health Past Accepting new patients

Locations

596 Anderson Ave
Ste 305
Cliffside Park, NJ 07010
Phone (201) 654-4086

570 N Broad St
Ste 3
Elizabeth, NJ 07208
Phone (888) 500-9661

96 Linwood Plz
Fort Lee, NJ 07024
Phone (201) 681-5066

516 Bergen St
Newark, NJ 07108
Phone (201) 633-5773

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

9 W Broadway
#2
Paterson, NJ 07505
Phone (973) 214-0670

9 W Broadway
Paterson, NJ 07505
Phone (973) 345-1883

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

Organizations & group practices 7

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553385600000",
    "number": "1447710553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 ORANGE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072161",
            "telephone_number": "201-463-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 ORANGE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072161",
            "telephone_number": "201-463-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNANABU",
        "first_name": "LOUISMARIE",
        "middle_name": "BERNADINE",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2019-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00902200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.