Ndidiamaka Onyeanwuli Nwaka, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

83158 Issued in GA

Practice address

200 Wisteria Dr
Gainesville, GA 30501

Phone

(770) 219-5407

NPI assigned

Sep 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HAJBDD/Endpoint/HAJBDD

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.

• Maysprings Behavioral Health LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Smyrna, GA
  • NPI 1689393332
  NPD Authorized official
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1639487036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WISTERIA DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-219-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18714 N Village",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422454",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "fax_number": "240-310-1927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "916 48th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192918",
            "country_code": "US",
            "telephone_number": "718-283-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 Winn Way",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300301707",
            "country_code": "US",
            "telephone_number": "404-294-3835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8338",
            "fax_number": "717-531-6250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18714 N Village",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422454",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "fax_number": "240-310-1927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAKA",
        "first_name": "NDIDIAMAKA",
        "middle_name": "ONYEANWULI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0079377",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD475758",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "83158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099304200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark M Novotny, O.D.
• Numind Wellness LLC
• Valerie Lisette Nunez
• Nunova Health LLC (NuNova Health & Image)
• Gillian C.J. Nurhonen, OTRL
• Deborah N Nwosu
• Megan O'Brien, LCSW
• Shannon O'Carroll, APC
• Caroline Patton O'Hearn, DMD
• Ashley Drew O'Neal, CRNA

• Psychiatry Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.