Individual provider Active NPI

Uche Ukeagu

  • Chiropractor
  • Maitland, FL
National Provider Identifier
1033599964
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11550 Issued in FL
Practice address
100 E Sybelia Ave Ste 217
Maitland, FL 32751-4757
Phone
(954) 415-5931
NPI assigned
Jun 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11550 FL Primary

Addresses

Primary practice location

100 E Sybelia Ave Ste 217
Maitland, FL 32751-4757

Mailing address

850 NW 86TH Ave Apt 501
Plantation, FL 33324-1244
Phone (954) 415-5931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230524000997 FL Practitioner - Chiropractic 3375966641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 E Sybelia Ave
Suite 217
Maitland, FL 32751-4757
Phone (407) 887-6568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 11550FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Impact Chiropractic, Inc Chiropractor CurrentSince Jun 1, 2023 Accepting new patients
Gateway Medical Supply LLC Current Accepting new patients

Locations

100 E Sybelia Ave
Ste 217
Maitland, FL 32751
Phone (407) 887-6568

Organizations & group practices 2

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": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1033599964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 NW 86TH AVE APT 501",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241244",
            "telephone_number": "954-415-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E SYBELIA AVE STE 217",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514757",
            "telephone_number": "954-415-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKEAGU",
        "first_name": "UCHE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.