Josephine Akom Igwacho, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4523 Issued in MN

Practice address

1201 Harmon PL
Suite 103
Minneapolis, MN 55403-2043

Phone

(612) 313-3240

Fax

(612) 338-5902

NPI assigned

Jul 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1972986974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HARMON PL",
            "address_2": "SUITE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032043",
            "telephone_number": "612-313-3240",
            "fax_number": "612-338-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HARMON PL",
            "address_2": "SUITE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032043",
            "telephone_number": "612-313-3240",
            "fax_number": "612-338-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGWACHO",
        "first_name": "JOSEPHINE",
        "middle_name": "AKOM",
        "name_prefix": "Dr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "4523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadifo Abshir Igal
• Musa Ige
• Ignatia Integrative Therapy PLLC
• Ignite Child Developmental Services P.a.
• Ignite Dental PLLC
• Vivian Mah Igwacho, CNP
• Jacqueline Marie Ihinger
• Zachary Dylan Ihli, NP
• Daniel Ihnat, MD
• IHS Regency PC

• Psychiatric/Mental Health Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.