Individual provider Active NPI

Ejine Okoroafor, M.D.

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1003164377
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15734 Issued in NV
Practice address
5440 W Sahara Ave
Suite 202
Las Vegas, NV 89146-0355
Phone
(914) 426-7774
NPI assigned
Aug 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 15734 NV Primary

Addresses

Primary practice location

5440 W Sahara Ave
Suite 202
Las Vegas, NV 89146-0355

Mailing address

5440 W Sahara Ave
Suite 202
Las Vegas, NV 89146-0355
Phone (914) 426-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001025 NV Practitioner - Psychiatry 6800113812 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6765 W Charleston Blvd
Suite 110
Las Vegas, NV 89146-2001
Phone (702) 463-4377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anywhere Clinic LLC Psychiatry CurrentSince Aug 21, 2020 Accepting new patients
State of Nevada Current Accepting new patients
State of Nevada CurrentSince Dec 7, 2015 Accepting new patients
Southern Nevada Adult Mental Health CurrentSince Dec 7, 2015 Accepting new patients
Ejine Okoroafor M D LTD Psychiatry CurrentSince Mar 17, 2015 Accepting new patients

Locations

4150 Technology Way
Ste 300
Carson City, NV 89706
Phone (775) 684-4200

4150 Technology Way
Ste 100
Carson City, NV 89706

1909 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 471-0420

6161 W Charleston Blvd
Las Vegas, NV 89146
Phone (702) 486-4400

6765 W Charleston Blvd
Ste 110
Las Vegas, NV 89146
Phone (702) 463-4377

4029 Dean Martin Dr
Las Vegas, NV 89103
Phone (702) 919-1508

11700 W Charleston Blvd
#17036
Las Vegas, NV 89135

5440 W Sahara Ave
Ste 202
Las Vegas, NV 89146
Phone (702) 296-4844

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1003164377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 W SAHARA AVE",
            "address_2": "SUITE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460355",
            "telephone_number": "914-426-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 W SAHARA AVE",
            "address_2": "SUITE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460355",
            "telephone_number": "914-426-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOROAFOR",
        "first_name": "EJINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-17",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "15734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.