Individual provider Active NPI

Christiana Enweonwu

  • Gerontology Nurse Practitioner
  • Union, NJ
National Provider Identifier
1508251232
Registry record updated Jun 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00571100 Issued in NJ
Practice address
353 Summit
Union, NJ 07083
Phone
(908) 468-6105
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00571100 NJ Primary

Addresses

Primary practice location

353 Summit
Union, NJ 07083

Mailing address

353 Summit Rd
Union, NJ 07083-7745

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
I20150708002176 NJ Practitioner - Nurse Practitioner 5395057012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newark Community Health Centers IncGroup PAC ID 2163334665, 39 clinicians

Practice addresses (Care Compare)

101 Ludlow St
Newark, NJ 07114-1108
Phone (973) 565-0355

37 N Day St
Orange Community Health Center
Orange, NJ 07050-3608
Phone (973) 395-2611

741 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

751 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

92 -96 Ferry St
Ironbound Medical and Dental Clinic
Newark, NJ 07104-4309
Phone (973) 803-4510

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eoh Acquisition Group, LLC Past Accepting new patients
University Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christiana.enweonwu@nchc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434240000000",
    "number": "1508251232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 SUMMIT RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 SUMMIT",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-468-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENWEONWU",
        "first_name": "CHRISTIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00571100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.