Elsie Oge Izunwanne Adibe, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61295115 Issued in WA

Practice address

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-4342

Phone

(253) 968-2252

NPI assigned

Mar 7, 2019

Last updated

Jul 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Northeast Health Services, LLC

  dba Hyland Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment NPD
• Divine Care Health and Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
  • NPI 1932861614
  NPD Authorized official

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1962960930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST STE 300",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "508-586-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984314342",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023014342",
            "country_code": "US",
            "telephone_number": "508-586-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADIBE",
        "first_name": "ELSIE",
        "middle_name": "OGE IZUNWANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1028699",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2330477",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61295115",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "946868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ulrika Hilde Addington
• Clyde R Addison, MD
• Bolajoko Renee Adeniyi, M.D.
• Oluwaseun Munir Adewusi
• Afamefuna Ndubuisi Adibe
• Brooke Adimoraegbu
• Rikia Lamaria Adkinson
• Sarah L Adkisson, OT
• Lauren Adlao, MOTR/L
• Adonai Counseling & Employment Inc.

• Psychiatric/Mental Health Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.