Individual provider Active NPI

Chinwe Obi-Walker, APRN

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1912382490
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8242 Issued in MN
Practice address
425 20TH Ave S
Minneapolis, MN 55454-4400
Phone
(612) 332-4973
NPI assigned
Jul 24, 2015
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 8242 MN Primary
Administrator Registered Nurse 163WA2000X R 210932-3 MN
Home Health Registered Nurse 163WH0200X R 210932-3 MN

Addresses

Primary practice location

425 20TH Ave S
Minneapolis, MN 55454-4400

Mailing address

856 University Ave W
Saint Paul, MN 55104-4807

Other practice location 1

856 University Ave W
Saint Paul, MN 55104-4807
Phone (651) 665-9795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R 210932-3MNMDAdministrator Registered Nurse
8242MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Healthcare Corporation Past Accepting new patients

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, 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": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1912382490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 20TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554544400",
            "telephone_number": "612-332-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "856 University Ave W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551044807",
            "country_code": "US",
            "telephone_number": "651-665-9795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBI-WALKER",
        "first_name": "CHINWE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8242",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MN",
            "license": "R 210932-3",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "R 210932-3",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.