Mary Phubong Nkwain

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1093159 Issued in TX

Practice address

8535 Tom Slick
San Antonio, TX 78229-3367

Phone

(210) 616-3900

NPI assigned

Aug 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mnkwain50692@direct.utmsa.com

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.

• Senior Psychcare of Dallas I, PLLC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1942596903

  Psychiatric/Mental Health

  Medicare reassignment NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1669109666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-450-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-616-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "329 Sanford Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286552576",
            "country_code": "US",
            "telephone_number": "828-430-9120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NKWAIN",
        "first_name": "MARY",
        "middle_name": "PHUBONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1093159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Kofi Nkansah-Dwamena
• Ifeoma May Nkemakolam, PMHNP-BC
• Yolanda Michelle Nkemakolam, RN BSN
• Eugenie Nkengaka Nkemka, N/A
• Medrick Nkengafac, RN
• Sandra M Nkwenti, ADMINISTRATOR
• Nluc PLLC
• Nluc PLLC
• Nluc PLLC
• Nluc PLLC

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.