Individual provider Active NPI

Nathaniel Maduakolam Nwosu, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Frisco, TX
National Provider Identifier
1962134312
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1073107 Issued in TX
Practice address
11347 Henderson Dr
Frisco, TX 75035-8852
Phone
(646) 530-2521
NPI assigned
Jun 24, 2022
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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 1073107 TX Primary

Addresses

Primary practice location

11347 Henderson Dr
Frisco, TX 75035-8852

Mailing address

11347 Henderson Dr
Frisco, TX 75035-8852
Phone (646) 530-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220816000763 TX Practitioner - Nurse Practitioner 4789067232 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Texas PLLC CurrentSince Aug 3, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 10, 2022 Accepting new patients
CS Pacs 3 Southwest, LLC CurrentSince Sep 9, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince Aug 3, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

999 Raintree Cir
Allen, TX 75013
Phone (972) 390-8088

201 Sycamore School Rd
#R
Fort Worth, TX 76134
Phone (817) 293-7610

5400 Clearfork Main St
Fort Worth, TX 76109
Phone (817) 433-7000

6301 Oakmont Blvd
Ft Worth, TX 76132
Phone (682) 250-4055

415 Indian Oaks Dr
Harker Hts, TX 76548
Phone (254) 699-5051

721 W Mulberry St
Holiday Lakes, TX 77515
Phone (979) 848-0279

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

2101 W Northgate Dr
Irving, TX 75062
Phone (972) 255-4460

208 S Utah St
La Porte, TX 77571
Phone (281) 471-1810

811 Garner Rd
Pasadena, TX 77502
Phone (713) 473-0687

6211 S New Braunfels Ave
#T
San Antonio, TX 78223
Phone (210) 531-0569

424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431

Organizations & group practices 4

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": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1962134312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11347 HENDERSON DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358852",
            "telephone_number": "646-530-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11347 HENDERSON DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358852",
            "telephone_number": "646-530-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "NATHANIEL",
        "middle_name": "MADUAKOLAM",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1073107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.