Individual provider Active NPI

Chidumga Mercy Onuigbo-Oben, FNP

  • Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1790924413
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F12200684 Issued in MA
Practice address
10 Boynton St
Lynn, MA 01904-2505
Phone
(617) 816-6209
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2257742 MA
Nurse Practitioner 363L00000X F12200684 MA Primary

Addresses

Primary practice location

10 Boynton St
Lynn, MA 01904-2505

Mailing address

95 Pleasant St
Lynn, MA 01901-1524
Phone (781) 230-8403

Other practice location 1

95 Pleasant St
Lynn, MA 01901-1524
Phone (781) 230-8403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230301001315 MA Practitioner - Nurse Practitioner 0345613915 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F12200684MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services CurrentSince Dec 19, 2022 Accepting new patients
Eliot Community Human Services CurrentSince Dec 19, 2022 Accepting new patients

Locations

86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1790924413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524",
            "telephone_number": "781-230-8403",
            "fax_number": "781-592-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BOYNTON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042505",
            "telephone_number": "617-816-6209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019011524",
            "country_code": "US",
            "telephone_number": "781-230-8403",
            "fax_number": "781-592-0581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUIGBO-OBEN",
        "first_name": "CHIDUMGA",
        "middle_name": "MERCY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2257742",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "F12200684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.