Individual provider Active NPI

Kelechi Uche Uduma

  • Psychiatric/Mental Health Nurse Practitioner
  • Edwardsville, IL
National Provider Identifier
1487480752
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025034856 Issued in MO
Practice address
1 Hairpin Drive
Edwardsville, IL 62026-0001
Phone
(314) 745-4673
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 2019030421 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025034856 MO Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 041561779 IL

Addresses

Primary practice location

1 Hairpin Drive
Edwardsville, IL 62026-0001

Mailing address

168 Behlmann Meadows Way
Florissant, MO 63034-2863
Phone (314) 745-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260319001092 MO Practitioner - Nurse Practitioner 4981188836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

168 Behlmann Meadows Way
Florissant, MO 63034-2863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041561779ILMDPsychiatric/Mental Health Registered Nurse
2019030421MOMDPsychiatric/Mental Health Registered Nurse
2025034856MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Place Psychiatry LLC CurrentSince Mar 17, 2026 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1487480752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 BEHLMANN MEADOWS WAY",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630342863",
            "telephone_number": "314-745-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAIRPIN DRIVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620260001",
            "telephone_number": "314-745-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDUMA",
        "first_name": "KELECHI",
        "middle_name": "UCHE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2019030421",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025034856",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041561779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.