Ejovwoke Ughwanogho

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN164479 Issued in GA

Practice address

680 Old Johnson Rd
Lawrenceville, GA 30045-6251

Phone

(470) 796-1471

Fax

(470) 796-1471

NPI assigned

Jan 26, 2026

Sex

Male

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 FL

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

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Instic Health LLC

  • Psychiatry Physician
  • Plant City, FL
  • NPI 1811519234
  Medicare reassignment

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

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1669321477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 OLD JOHNSON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456251",
            "telephone_number": "470-796-1471",
            "fax_number": "470-796-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 OLD JOHNSON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456251",
            "telephone_number": "470-796-1471",
            "fax_number": "470-796-1471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 S Apopka Ave",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524803",
            "country_code": "US",
            "telephone_number": "470-796-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UGHWANOGHO",
        "first_name": "EJOVWOKE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN164479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tinisha Tyre
• Sarah Tyser, RN
• Kaitlin Tyson
• Liberty Odinamadu Ubani, AGANCP-BC
• Gontse Theodeltia Ugbabe, RN
• Woojoo Uhn, LCSW
• Uhs of Summitridge, LLC
• Uhs of Summitridge, LLC
• Chigozie Grace Uko, NP-C
• Ultralite Enterprises, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.