Theodora Chidiebere Nwosu, CRNP, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00315300 Issued in NJ

Practice address

602 Liberty PL
Sicklerville, NJ 08081-5700

Phone

(856) 776-7540

Fax

(856) 776-7512

NPI assigned

Aug 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jandt Behavioral Health and Counseling Services LLCGroup PAC ID 3274849377, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• J&T Behavioral Health and Counseling Services LLC

  • Adult Mental Health Clinic/Center
  • Sicklerville, NJ
  • NPI 1497149041
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1740569904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LIBERTY PL",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815715",
            "telephone_number": "856-776-7540",
            "fax_number": "856-776-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 LIBERTY PL",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815700",
            "telephone_number": "856-776-7540",
            "fax_number": "856-776-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "THEODORA",
        "middle_name": "CHIDIEBERE",
        "name_prefix": "Mrs.",
        "credential": "CRNP, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011240",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00315300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Nicholson
• Shakia Nicholson
• NJ Mentor
• Columbus Nwosu
• Jacob C Nwosu, PA-C
• Linet Nyakure
• Oaks Integrated Care
• Oaks Integrated Care, Inc
• Ernest Obeng
• Adenike Ogunsanwo

• Nurse Practitioner in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.