Individual provider Active NPI

Ndidi Okanu, NP-C

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1740600311
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP50000385 Issued in DC
Practice address
3348 W 87TH St
Chicago, IL 60652-3767
Phone
(773) 776-4471
Fax
(773) 564-3510
NPI assigned
Apr 22, 2014
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209011407 IL
Nurse Practitioner 363L00000X R254241 MD
Nurse Practitioner 363L00000X NP50000385 DC Primary

Addresses

Primary practice location

3348 W 87TH St
Chicago, IL 60652-3767

Mailing address

213 N Racine Ave
Suite 100
Chicago, IL 60607-1644
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20230825001029 DC Practitioner - Nurse Practitioner 5395969398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

5530 Wisconsin Ave
1150 Chvy CHS Pulm Assoc
Chevy Chase, MD 20815-4404
Phone (301) 656-7374

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP50000385DCMDNurse Practitioner
R254241MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jun 14, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 14, 2023 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1740600311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N RACINE AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071644",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523767",
            "telephone_number": "773-776-4471",
            "fax_number": "773-564-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKANU",
        "first_name": "NDIDI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011407",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R254241",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "NP50000385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.