Individual provider Active NPI

Monday Ogbeibor, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Kewanee, IL
National Provider Identifier
1770177636
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704321230 Issued in MI
Practice address
110 N Burr Blvd
Kewanee, IL 61443-8377
Phone
(309) 852-0197
NPI assigned
Feb 22, 2021
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 4704321230 MI Primary

Addresses

Primary practice location

110 N Burr Blvd
Kewanee, IL 61443-8377

Mailing address

501 Pine Knoll Cir
Battle Creek, MI 49014-7725
Phone (269) 419-1701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210625001259 IL Practitioner - Nurse Practitioner 2466853692 Reassigns benefits to 2 organizations
I20240228001002 MI Practitioner - Nurse Practitioner 2466853692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

625 Harrison St
Kalamazoo, MI 49007-3681
Phone (989) 203-2133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Henry CurrentSince Apr 26, 2021 Accepting new patients
True Light Wellness Psychiatric/Mental Health CurrentSince Feb 1, 2024 Accepting new patients
County of Henry CurrentSince Apr 26, 2021 Accepting new patients

Locations

110 N Burr Blvd
Kewanee, IL 61443
Phone (309) 852-0197

2501 Chatham Rd
Springfield, IL 62704
Phone (312) 625-0078

625 Harrison St
Kalamazoo, MI 49007
Phone (269) 323-1954

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": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1770177636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PINE KNOLL CIR",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490147725",
            "telephone_number": "269-419-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N BURR BLVD",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614438377",
            "telephone_number": "309-852-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBEIBOR",
        "first_name": "MONDAY",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704321230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewanee, IL

Sources for this page

Verify at the official NPI Registry.