Individual provider Active NPI

Felicia Ugborugbo

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1902685993
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
297761 Issued in AZ
Practice address
3448 E Amber LN
Gilbert, AZ 85296-1839
Phone
(480) 510-6615
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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 297761 AZ Primary

Addresses

Primary practice location

3448 E Amber LN
Gilbert, AZ 85296-1839

Mailing address

5501 N 19TH Ave Ste 425
Phoenix, AZ 85015-2481
Phone (480) 510-6615

Other practice location 1

5501 N 19th Ave Ste 425
Phoenix, AZ 85015-2481
Phone (480) 510-6615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240214001047 AZ Practitioner - Nurse Practitioner 8325482789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Tower Recovery LLCGroup PAC ID 3274073523, 3 clinicians

Practice addresses (Care Compare)

5501 N 19TH Ave
Suite 425
Phoenix, AZ 85015-2481
Phone (725) 666-1636

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Tower Recovery, LLC CurrentSince Sep 2, 2024 Accepting new patients

Locations

5501 N 19th Ave
Ste 425
Phoenix, AZ 85015
Phone (602) 492-9800

5501 N 19th Ave
Phoenix, AZ 85015
Phone (480) 219-5769

Organizations & group practices 1

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": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1902685993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152481",
            "telephone_number": "480-510-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3448 E AMBER LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961839",
            "telephone_number": "480-510-6615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 N 19th Ave Ste 425",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850152481",
            "country_code": "US",
            "telephone_number": "480-510-6615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UGBORUGBO",
        "first_name": "FELICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "297761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.