Jude Osagie Ukpebor, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704363555 Issued in MI

Practice address

27200 Lahser Rd Ste 100
Southfield, MI 48034-2137

Phone

(248) 208-9215

Fax

(248) 208-9217

NPI assigned

Apr 19, 2024

Sex

Male

Sole proprietor

Yes

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 MI

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Rehabilitation Clinics, Inc.Group PAC ID 8022039742, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Metropolitan Rehabilitation Clinics, Inc.

  • Methadone Clinic
  • Oak Park, MI
  • NPI 1811020035

  Single Specialty

  Medicare reassignment Care Compare group NPD
• St Jude Therapy Center Staffing

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
  • NPI 1538999784

  Single Specialty

  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MI, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1669227161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27200 LAHSER RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342137",
            "telephone_number": "248-208-9215",
            "fax_number": "248-208-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27200 LAHSER RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342137",
            "telephone_number": "248-208-9215",
            "fax_number": "248-208-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKPEBOR",
        "first_name": "JUDE",
        "middle_name": "OSAGIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704363555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Ubom, DO
• Imo Patricia Udo-Inyang, MD
• Patricia A Uhrin, CRNA
• Essence Latoya Uke, LLMSW
• Uko Ekaiko
• Suzanne Ulman
• Ultimate Medical Care PLC
• Ultimate Rehab Center LLC
• Ultra Care Medical Equipment, Inc.
• Ultra Diagnostic Services PC

• Psychiatric/Mental Health Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.