Individual provider Active NPI

Chinedu Ibemadu, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Darien, CT
National Provider Identifier
1679270979
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11594 Issued in CT
Practice address
30 Old Kings Hwy S FL 1
Darien, CT 06820-4526
Phone
(800) 465-3203
NPI assigned
Feb 8, 2023
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11594 CT Primary

Addresses

Primary practice location

30 Old Kings Hwy S FL 1
Darien, CT 06820-4526

Mailing address

64 Parkview Dr
Avon, CT 06001-3453
Phone (203) 214-5586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230516003457 CT Practitioner - Nurse Practitioner 6901262054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Village for Families and Children IncGroup PAC ID 3072579895, 16 clinicians

Practice addresses (Care Compare)

331 Wethersfield Ave
Hartford, CT 06114-1420
Phone (860) 236-4511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11594CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newleaf Behavioral Health Partners LLC Psychiatric/Mental Health CurrentSince Dec 21, 2025 Accepting new patients
Harvest Healthcare LLC CurrentSince Apr 7, 2023 Accepting new patients
The Village for Families & Children, Inc. CurrentSince Aug 12, 2023 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

1680 Albany Ave
Hartford, CT 06105
Phone (860) 236-4511

331 Wethersfield Ave
Hartford, CT 06114
Phone (860) 236-4511

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1679270979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PARKVIEW DR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013453",
            "telephone_number": "203-214-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 OLD KINGS HWY S FL 1",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204526",
            "telephone_number": "800-465-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBEMADU",
        "first_name": "CHINEDU",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "11594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, CT

Sources for this page

Verify at the official NPI Registry.