Individual provider Active NPI

Poweielatei Mary Nkengla, LCSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1578065256
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010217 Issued in VA
Practice address
224 Great Bridge Blvd
Chesapeake, VA 23320-3904
Phone
(757) 547-9334
Fax
(757) 819-6292
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4020C AL
Clinical Social Worker 1041C0700X 0904010217 VA Primary

Addresses

Primary practice location

224 Great Bridge Blvd
Chesapeake, VA 23320-3904

Mailing address

7079 Kirby Cres
Norfolk, VA 23505-4214
Phone (334) 221-2204

Other names 1

  • Poweielatei Mary Iyegha Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180516000053 VA Practitioner - Clinical Social Worker 0749544989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of ChesapeakeGroup PAC ID 6204885601, 24 clinicians

Practice addresses (Care Compare)

224 Great Bridge Blvd
Chesapeake, VA 23320-3904
Phone (757) 547-9334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4020CALMDClinical Social Worker
0904010217VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
City of Chesapeake CurrentSince Mar 12, 2018 Accepting new patients
City of Chesapeake CurrentSince Mar 12, 2018 Accepting new patients

Locations

224 Great Bridge Blvd
Chesapeake, VA 23320
Phone (757) 547-9334

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1578065256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7079 KIRBY CRES",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054214",
            "telephone_number": "334-221-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 GREAT BRIDGE BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203904",
            "telephone_number": "757-547-9334",
            "fax_number": "757-819-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKENGLA",
        "first_name": "POWEIELATEI",
        "middle_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4020C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POWEIELATEI",
            "last_name": "IYEGHA",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.