Individual provider Active NPI

Chiatuogu Ukaga

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1720296635
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R 143046-2 Issued in MN
Practice address
1239 Payne Ave
Suite 200
Saint Paul, MN 55130-3538
Phone
(651) 209-8350
Fax
(651) 209-8353
NPI assigned
May 21, 2007
Last updated
May 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R 143046-2 MN Primary

Addresses

Primary practice location

1239 Payne Ave
Suite 200
Saint Paul, MN 55130-3538

Mailing address

8814 Pheasant Run Rd
Woodbury, MN 55125-8887
Phone (651) 702-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20070620000024 MN Practitioner - Nurse Practitioner 9133228935 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 143046-2MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Apr 3, 2017 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Apr 3, 2017 Accepting new patients
St. Paul Family Medical Center PA PastSince Aug 29, 2022 Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

451 Dunlap St N
Saint Paul, MN 55104
Phone (651) 647-2100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12803/brand/1/csg/1/fhir/r4

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, 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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1720296635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8814 PHEASANT RUN RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258887",
            "telephone_number": "651-702-5631",
            "fax_number": "651-731-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 PAYNE AVE",
            "address_2": "SUITE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303538",
            "telephone_number": "651-209-8350",
            "fax_number": "651-209-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKAGA",
        "first_name": "CHIATUOGU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 143046-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.