MEDICARE: LUMORA PSYCHIATRIC & REJUVENATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1245171271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMORA PSYCHIATRIC & REJUVENATION

Provider Business Mailing Address
First Line	:	110 N ROBINSON ST STE 305
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 N ROBINSON ST STE 305
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4461
Country	:	US
Telephone Number	:	804-773-1571
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & CLINICAL DIRECTOR
Name	:	MR. MADU NWAJIAKU
Credential	:	NP
Telephone Number	:	804-773-1571

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	06/11/2026

Similar Medicare Providers

1538348388 — CENTER FOR INTERNAL MEDICINE HYPER KIDNEY DISEASE & CRITICAL CARE INC
Practice Location Address:

110 N ROBINSON ST STE 305
RICHMOND, VA
23220-4461

Practice Phone: 804-780-2610
Practice Fax:

1629649868 — TALK WORK HEAL PROFESSIONAL SERVICES LLC
Practice Location Address:

110 N ROBINSON ST STE 300
RICHMOND, VA
23220-4461

Practice Phone: 804-937-1164
Practice Fax: 804-507-2471

1598532483 — MR. MADU J NWAJIAKU NP
Practice Location Address:

110 N ROBINSON ST STE 305
RICHMOND, VA
23220-4461

Practice Phone: 804-773-1571
Practice Fax:

1700463395 — PAUL DONALD CHRISS ZIMMER
Practice Location Address:

1308 SHERWOOD AVE
RICHMOND, VA
23220-1210

Practice Phone: 804-828-3137
Practice Fax: 804-828-9493

1396677597 — BLAYNE M JONES
Practice Location Address:

1527 W MAIN ST APT 14
RICHMOND, VA
23220-4728

Practice Phone: 757-645-8906
Practice Fax:

1912454265 — MR. IVAN TOLBERT
Practice Location Address:

1702 DAKOTA AVE
RICHMOND, VA
23220-6911

Practice Phone: 804-477-7447
Practice Fax:

Directions to “LUMORA PSYCHIATRIC & REJUVENATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.