Adaku Stacey Nwagbara

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

09579 Issued in MD

Practice address

6901 N Charles St
Towson, MD 21204-3780

Phone

(443) 809-4130

NPI assigned

Jan 19, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic and Neurological Rehab IncGroup PAC ID 6507159126, 368 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopaedic and Neurological Rehab Inc

  • Rehabilitation Clinic/Center
  • Billings, MT
  • NPI 1225496540

  CA

  Medicare reassignment Care Compare group NPD
• Baltimore County Public Schools

  • Local Education Agency (LEA)
  • Towson, MD
  • NPI 1326188509
  NPD
• Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc

  • Rehabilitation Clinic/Center
  • Tustin, CA
  • NPI 1548940885
  NPD
• A Change in Trajectory, Inc.

  • Behavior Analyst
  • Van Nuys, CA
  • NPI 1750646667
  NPD (past)

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1497292189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 DOVER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072901",
            "telephone_number": "909-499-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212043780",
            "telephone_number": "443-809-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7226 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914052003",
            "country_code": "US",
            "telephone_number": "818-235-1414",
            "fax_number": "818-945-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAGBARA",
        "first_name": "ADAKU",
        "middle_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "09579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blaise Junior Nzoukou

• Occupational Therapist in Towson, MD
• Providers in Towson, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.