Individual provider Active NPI

Ngozichukwu Okwara

  • Psychiatric/Mental Health Nurse Practitioner
  • Gloucester City, NJ
National Provider Identifier
1922820539
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15220800 Issued in NJ
Practice address
822 Klemm Ave
Gloucester City, NJ 08030-1627
Phone
(856) 237-3597
NPI assigned
Oct 26, 2024
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 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 26NJ15220800 NJ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP031096 PA

Addresses

Primary practice location

822 Klemm Ave
Gloucester City, NJ 08030-1627

Mailing address

2 Canary Rd
Levittown, PA 19057-1602
Phone (215) 910-1870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250618002424 PA Practitioner - Nurse Practitioner 4183133663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone 21547370337124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15220800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Council for Mental Health & Mental Retardation Inc Single Specialty CurrentSince Apr 16, 2025 Accepting new patients
Community Council for Mental Health & Mental Retardation Inc. CurrentSince Apr 16, 2025 Accepting new patients
St Remi LLC PastSince Oct 27, 2024 Accepting new patients

Locations

4900 Wyalusing Ave
Philadelphia, PA 19131
Phone (215) 473-7033

Organizations & group practices 3

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": "1729900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1922820539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CANARY RD",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190571602",
            "telephone_number": "215-910-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 KLEMM AVE",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301627",
            "telephone_number": "856-237-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKWARA",
        "first_name": "NGOZICHUKWU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-26",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15220800",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP031096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester City, NJ

Sources for this page

Verify at the official NPI Registry.