Individual provider Active NPI

Otega Ojukwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1588147235
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9186628 Issued in FL
Practice address
18777 NW 78TH PL
Hialeah, FL 33015-2768
Phone
(305) 978-0288
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9186628 FL
Primary Care Nurse Practitioner 363LP2300X APRN9186628 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9186628 FL Primary

Addresses

Primary practice location

18777 NW 78TH PL
Hialeah, FL 33015-2768

Mailing address

18777 NW 78TH PL
Hialeah, FL 33015-2768
Phone (305) 978-0288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210416000283 FL Practitioner - Nurse Practitioner 6709294846 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9186628FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Therapy Services, Inc CurrentSince Jul 17, 2021 Accepting new patients

Locations

6425 Pensacola Blvd
#13
Pensacola, FL 32505
Phone (850) 471-0017

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1588147235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18777 NW 78TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152768",
            "telephone_number": "305-978-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18777 NW 78TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152768",
            "telephone_number": "305-978-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "OTEGA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9186628",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9186628",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9186628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.