Individual provider Active NPI

Sussan C Nwogwugwu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1912560954
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP141239 Issued in TX
Practice address
715 N Fielder Rd
Arlington, TX 76012-4695
Phone
(682) 220-9615
NPI assigned
Apr 16, 2019
Last updated
Apr 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021812 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP141239 TX Primary

Addresses

Primary practice location

715 N Fielder Rd
Arlington, TX 76012-4695

Mailing address

7809 Salton LN
Arlington, TX 76001-5901
Phone (213) 984-8478

Other practice location 1

29101 Hospital Rd
Lake Arrowhead, CA 92352-9706
Phone (909) 436-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211119001067 TX Practitioner - Nurse Practitioner 6608265244 Reassigns benefits to 2 organizations
I20240924000653 CA Practitioner - Nurse Practitioner 6608265244 Reassigns benefits to 1 organization
I20250512000582 WA Practitioner - Nurse Practitioner 6608265244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1780 Barnes Blvd SW
Tumwater, WA 98512-0410
Phone (972) 449-0540

2805 NE 129TH St
Vancouver, WA 98686-3324
Phone (972) 449-0540

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC CurrentSince Mar 29, 2025 Accepting new patients
Forefront-Rush Medical Service PA CurrentSince Feb 11, 2025 Accepting new patients
San Bernardino Mountains Community Hospital District CurrentSince Oct 1, 2024 Accepting new patients
Forefront-Rosenzweig Medical Services Professional Corporation CurrentSince May 16, 2025 Accepting new patients
Emerald Behavioral Health Services LLC Psychiatric/Mental Health CurrentSince Nov 1, 2021 Accepting new patients

Locations

1901 Medi Park Dr
Ste 2058
Amarillo, TX 79106
Phone (806) 354-9540

1901 Medi Park Dr
Ste 219
Amarillo, TX 79106
Phone (806) 356-7744

3201 E Pioneer Pkwy
Ste 40
Arlington, TX 76010
Phone (212) 984-8478

1717 Main St
Ste 5850
Dallas, TX 75201
Phone (469) 694-5512

7356 15th Ave NW
Seattle, WA 98117

1780 Barnes Blvd SW
Tumwater, WA 98512
Phone (212) 993-7809

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.

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1912560954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7809 SALTON LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760015901",
            "telephone_number": "213-984-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "682-220-9615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29101 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Arrowhead",
            "state": "CA",
            "postal_code": "923529706",
            "country_code": "US",
            "telephone_number": "909-436-3235",
            "fax_number": "909-336-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWOGWUGWU",
        "first_name": "SUSSAN",
        "middle_name": "C",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021812",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP141239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.