Individual provider Active NPI

Chima Emmanuel Egwim, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oroville, CA
National Provider Identifier
1528792546
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025983 Issued in CA
Practice address
2145 5TH Ave
Oroville, CA 95965-5870
Phone
(530) 534-5394
NPI assigned
Jul 14, 2022
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1101546 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61378115 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025983 CA Primary
Registered Nurse 163W00000X 850058 TX

Addresses

Primary practice location

2145 5TH Ave
Oroville, CA 95965-5870

Mailing address

100 N Howard St Ste W
Spokane, WA 99201-0508

Other practice location 1

10592 Fuqua St Ste A311
Houston, TX 77089-1443
Phone (832) 757-9784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231002003376 CA Practitioner - Nurse Practitioner 3476926882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Feather River Tribal Health IncGroup PAC ID 4284799628, 29 clinicians

Practice addresses (Care Compare)

2145 5TH Ave
Oroville, CA 95965-5870
Phone (530) 534-5394

555 W Onstott Rd
Yuba City, CA 95993-5654
Phone (530) 534-5394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
850058TXMDRegistered Nurse
1101546TXMDPsychiatric/Mental Health Nurse Practitioner
AP61378115WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Feather River Tribal Health Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

2145 5th Ave
Oroville, CA 95965
Phone (530) 534-3793

555 W Onstott Rd
Yuba City, CA 95993
Phone (530) 751-8454

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1528792546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 5TH AVE",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959655870",
            "telephone_number": "530-534-5394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10592 Fuqua St Ste A311",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770891443",
            "country_code": "US",
            "telephone_number": "832-757-9784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGWIM",
        "first_name": "CHIMA",
        "middle_name": "EMMANUEL",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1101546",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61378115",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025983",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "850058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.