Individual provider Active NPI

Brian Ratemo Nyangoso

  • Psychiatric/Mental Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1609703222
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
224773 Issued in AR
Practice address
1912 Green Mountain Dr Apt V521
Little Rock, AR 72212-4066
Phone
(682) 241-5121
NPI assigned
May 7, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

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 224773 AR Primary

Addresses

Primary practice location

1912 Green Mountain Dr Apt V521
Little Rock, AR 72212-4066

Mailing address

1912 Green Mountain Dr Apt V521
Little Rock, AR 72212-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20260618002854 AR Practitioner - Nurse Practitioner 6305318502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Mental Health and Wellness LLCGroup PAC ID 0345574737, 24 clinicians

Practice addresses (Care Compare)

1150 E Matthews Ave
Suite 101a
Jonesboro, AR 72401-4356
Phone (870) 243-0424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
224773ARMDPsychiatric/Mental Health Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1609703222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 GREEN MOUNTAIN DR APT V521",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 GREEN MOUNTAIN DR APT V521",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124066",
            "telephone_number": "682-241-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYANGOSO",
        "first_name": "BRIAN",
        "middle_name": "RATEMO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-07",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "224773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.