Individual provider Active NPI

Assumpta Uzomachi Nwagwu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverdale, GA
National Provider Identifier
1508459876
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN138746 Issued in GA
Practice address
46 Upper Riverdale Rd SW
Riverdale, GA 30274-2622
Phone
(470) 945-0743
Fax
(470) 735-2802
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN138746 GA Primary

Addresses

Primary practice location

46 Upper Riverdale Rd SW
Riverdale, GA 30274-2622

Mailing address

46 Upper Riverdale Rd SW
Riverdale, GA 30274-2622
Phone (470) 945-0743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250204001970 GA Practitioner - Nurse Practitioner 1658801824 Reassigns benefits to 1 organization
I20260210003257 WA Practitioner - Nurse Practitioner 1658801824 Reassigns benefits to 1 organization
I20260320001014 AZ Practitioner - Nurse Practitioner 1658801824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN138746GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Single Specialty CurrentSince Dec 24, 2024 Accepting new patients
Reliable Behavioral Health Services Single Specialty CurrentSince Sep 29, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 2

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": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1508459876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742622",
            "telephone_number": "470-945-0743",
            "fax_number": "470-735-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742622",
            "telephone_number": "470-945-0743",
            "fax_number": "470-735-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAGWU",
        "first_name": "ASSUMPTA",
        "middle_name": "UZOMACHI",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN138746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.