Individual provider Active NPI

Nnennaya O Agwu, APRN

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1639959166
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29072 Issued in SC
Practice address
220 N Main St Ste 500
Greenville, SC 29601-2129
Phone
(800) 275-3243
NPI assigned
Oct 2, 2023
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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 29072 SC Primary
Family Nurse Practitioner 363LF0000X GAA-NP002631 GA
Student in an Organized Health Care Education/Training Program 390200000X 29072 SC

Addresses

Primary practice location

220 N Main St Ste 500
Greenville, SC 29601-2129

Mailing address

1601 Green Street Columbia
Columbia, SC 29208-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250107001730 GA Practitioner - Nurse Practitioner 5395273163 Reassigns benefits to 2 organizations
I20250514001791 SC Practitioner - Nurse Practitioner 5395273163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Behavioral Health Services of South Carolina PCGroup PAC ID 1759780380, 6 clinicians
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

220 N Main St
Suite 500
Greenville, SC 29601-2129
Phone (800) 275-3243

6711 La Roche Ave
Savannah, GA 31406-3101
Phone (248) 660-1220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP002631GAMDFamily Nurse Practitioner
29072SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest M PLLC CurrentSince May 24, 2025 Accepting new patients
Che Behavioral Health Services of South Carolina, P.C. CurrentSince Apr 21, 2025 Accepting new patients
Theoria Medical CurrentSince Oct 10, 2024 Accepting new patients

Locations

4000 Village View Dr
Gainesville, GA 30506
Phone (678) 450-3000

6711 La Roche Ave
Savannah, GA 31406
Phone (912) 354-8225

7300 Lester Rd
Union City, GA 30291
Phone (770) 703-2604

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

Organizations & group practices 3

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": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1639959166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GREEN STREET COLUMBIA",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292080001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N MAIN ST STE 500",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012129",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGWU",
        "first_name": "NNENNAYA",
        "middle_name": "O",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29072",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP002631",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "29072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.