Individual provider Active NPI

Nkem O Nkwonta, MD

  • Psychiatry Physician
  • Wilkes Barre, PA
National Provider Identifier
1629706577
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MT237485 Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001
Phone
(570) 808-2383
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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 AP61343784 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 281753 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5016677 NC
Psychiatry Physician 2084P0800X MT237485 PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001

Mailing address

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001
Phone (570) 808-2383

Other practice location 1

2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493
Phone (623) 323-9312

Other practice location 2

3511 Shannon Rd # 341
Durham, NC 27707-6330
Phone (844) 744-7944

Other practice location 3

1425 S Glenburnie Rd Ste 2
New Bern, NC 28562-2610
Phone (919) 230-8158

Other names 1

  • NK O Nkwonta Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20221110000261 NC Practitioner - Nurse Practitioner 7113394727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Hospital Dr
Louisburg, NC 27549-2256
Phone (252) 436-4143

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MT237485PAMDPsychiatry Physician
281753AZMDPsychiatric/Mental Health Nurse Practitioner
5016677NCMDPsychiatric/Mental Health Nurse Practitioner
AP61343784WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Nov 1, 2022 Accepting new patients
DLP Maria Parham Physician Practices LLC Psychiatry CurrentSince Nov 1, 2022 Accepting new patients
SG Integrative Psychiatry and Wellness PLLC Psychiatric/Mental Health CurrentSince Jun 4, 2023 Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

100 Hospital Dr
Louisburg, NC 27549
Phone (252) 438-4143

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1629706577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110001",
            "telephone_number": "570-808-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110001",
            "telephone_number": "570-808-2383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2375 E Camelback Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850163493",
            "country_code": "US",
            "telephone_number": "623-323-9312",
            "fax_number": "509-495-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3511 Shannon Rd # 341",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277076330",
            "country_code": "US",
            "telephone_number": "844-744-7944",
            "fax_number": "509-495-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 S Glenburnie Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285622610",
            "country_code": "US",
            "telephone_number": "919-230-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NKWONTA",
        "first_name": "NKEM",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61343784",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "281753",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016677",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MT237485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NK",
            "last_name": "NKWONTA",
            "middle_name": "O",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.