Individual provider Active NPI

Collette Ubajiogu

  • Family Nurse Practitioner
  • Westland, MI
National Provider Identifier
1669233292
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704334358 Issued in MI
Practice address
7879 Moonwood PL
Westland, MI 48185-9474
Phone
(734) 299-1282
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704334358 MI Primary
Registered Nurse 163W00000X 4704334358 MI

Addresses

Primary practice location

7879 Moonwood PL
Westland, MI 48185-9474

Mailing address

7879 Moonwood PL
Westland, MI 48185-9474
Phone (734) 299-1282

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241028001035 MI Practitioner - Nurse Practitioner 0446783682 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704334358MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Mar 11, 2025 Accepting new patients
Sage Medical Consultants PC CurrentSince Sep 1, 2024 Accepting new patients
Mazen S Afram M.D.P.C. CurrentSince Feb 1, 2025 Accepting new patients
Simmons Medical Group South Inc Past Accepting new patients

Locations

38525 8 Mile Rd
Livonia, MI 48152
Phone (734) 464-8800

1135 W University Dr
Ste 175
Rochester Hls, MI 48307
Phone (248) 650-4738

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: collette.ubajiogu.1@28492.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1669233292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7879 MOONWOOD PL",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481859474",
            "telephone_number": "734-299-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7879 MOONWOOD PL",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481859474",
            "telephone_number": "734-299-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBAJIOGU",
        "first_name": "COLLETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704334358",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704334358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

Verify at the official NPI Registry.