Individual provider Active NPI

Chika Ugwumba

  • Registered Nurse
  • Randolph, MA
National Provider Identifier
1447823570
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2297110 Issued in MA
Practice address
14 Fern Ave
Randolph, MA 02368-5406
Phone
(857) 204-8549
NPI assigned
Jul 16, 2021
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN2297110 MA Primary

Addresses

Primary practice location

14 Fern Ave
Randolph, MA 02368-5406

Mailing address

14 Fern Ave
Randolph, MA 02368-5406
Phone (857) 204-8549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240123003794 MA Practitioner - Nurse Practitioner 4385096528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Community Care IncGroup PAC ID 6709799885, 117 clinicians

Practice addresses (Care Compare)

117 Summer St
Somerville, MA 02143-2706
Phone (617) 354-2275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2297110MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Community Care, Inc. Single Specialty CurrentSince Nov 26, 2023 Accepting new patients

Locations

270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 564-8799

190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670

117 Summer St
Somerville, MA 02143
Phone (617) 284-5130

Organizations & group practices 1

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1447823570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FERN AVE",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023685406",
            "telephone_number": "857-204-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FERN AVE",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023685406",
            "telephone_number": "857-204-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGWUMBA",
        "first_name": "CHIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2297110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.