Individual provider Active NPI

Nkechinyere Doris Anyaegbu

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerset, NJ
National Provider Identifier
1720776263
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01473100 Issued in NJ
Practice address
220 Davidson Ave Ste 3063
Somerset, NJ 08873-4149
Phone
(732) 997-0707
Fax
(732) 907-0709
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 26NJ01473100 NJ Primary

Addresses

Primary practice location

220 Davidson Ave Ste 3063
Somerset, NJ 08873-4149

Mailing address

489 Stuyvesant Ave
Irvington, NJ 07111-2003
Phone (973) 393-6607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01473100NJMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1720776263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 STUYVESANT AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112003",
            "telephone_number": "973-393-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 DAVIDSON AVE STE 3063",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734149",
            "telephone_number": "732-997-0707",
            "fax_number": "732-907-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYAEGBU",
        "first_name": "NKECHINYERE",
        "middle_name": "DORIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01473100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.