NPIMap

Individual provider Active NPI

Chimnoya N Nwagwu-Youlo, MD

  • Hospitalist Physician
  • Rolla, MO
National Provider Identifier
1881910487
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2020030113 Issued in MO
Practice address
1050 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 364-9000
NPI assigned
Apr 8, 2010
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0441190 KS
Hospitalist Physician 208M00000X 01075285 IN
Hospitalist Physician 208M00000X 2020030113 MO Primary

Addresses

Primary practice location

1050 W 10TH St
Rolla, MO 65401-2905

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other identifiers 2

IdentifierTypeStateIssuer
201291200MedicaidIN
000000983476OtherINANTHEM PIN

Other names 1

  • Chimnoya Nwagwu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200930001385 MO Practitioner - Hospitalist 2769613611 Reassigns benefits to 2 organizations
I20240816002239 IL Practitioner - HospitalistPractitioner - Internal Medicine 2769613611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians
Altea Medical Illinois PLLCGroup PAC ID 5799129730, 30 clinicians

Practice addresses (Care Compare)

3354 Jerome LN
Cahokia, IL 62206-2604
Phone (877) 883-9430

430 N W St
Perryville, MO 63775-1359
Phone (573) 547-1011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0441190KSMDInternal Medicine Physician
01075285INMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altea Medical Illinois PLLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Altea Medical Missouri LLC Internal Medicine CurrentSince Jul 7, 2024 Accepting new patients
Post Acute Medical PLLC Internal Medicine CurrentSince Jul 23, 2024 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Urgent Care Center Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 232-7544

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

430 N West St
Perryville, MO 63775
Phone (273) 547-1011

610 Prigge Rd
Saint Louis, MO 63138
Phone (314) 741-9339

1441 Charic Dr
Wildwood, MO 63021
Phone (636) 394-2522

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bria of Chicago HeightsSouth Chicago Heights, IL, CCN 145898 Skilled nursing facility W-2 Managing Employee
Adp of the SNF		 Jan 1, 2024
Jan 8, 2025
Forest Edge Healthcare & Rehabilitation Center LPChicago, IL, CCN 145864 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024
Bria of River OaksBurnham, IL, CCN 145735 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024
Bria of Elmwood Park LPElmwood Park, IL, CCN 145419 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1881910487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAGWU-YOULO",
        "first_name": "CHIMNOYA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0441190",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01075285",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2020030113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201291200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000983476",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIMNOYA",
            "last_name": "NWAGWU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.