Individual provider Active NPI

Vivian T Uzonwune

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1578106795
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP020953 Issued in PA
Practice address
11600 Caroline Rd
Philadelphia, PA 19154-2110
Phone
(215) 632-6400
NPI assigned
Oct 21, 2019
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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 Practitioner 363LP0808X SP020953 PA Primary

Addresses

Primary practice location

11600 Caroline Rd
Philadelphia, PA 19154-2110

Mailing address

170 Norristown Rd
Warminster, PA 18974-4075
Phone (267) 265-5677

Other names 1

  • Vivian T Udaigwe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200309000249 PA Practitioner - Nurse Practitioner 1658709506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Belmont Behavioral Hospital, LLC CurrentSince Jan 22, 2020 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince May 16, 2022 Accepting new patients
Geisinger Clinic CurrentSince May 16, 2022 Accepting new patients
Belmont Behavioral Hospital, LLC Current Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

11600 Caroline Rd
Philadelphia, PA 19154
Phone (215) 632-6400

4200 Monument Rd
Philadelphia, PA 19131
Phone (215) 456-6611

Organizations & group practices 5

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": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1578106795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 NORRISTOWN RD",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189744075",
            "telephone_number": "267-265-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 CAROLINE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191542110",
            "telephone_number": "215-632-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZONWUNE",
        "first_name": "VIVIAN",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP020953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "UDAIGWE",
            "middle_name": "T",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.