Active NPI
Oluchukwu Nwachukwu
- Family Medicine Physician
- Jasper, IN
National Provider Identifier
1043056138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11023894A
- Practice address
- 966 Bartley St
Jasper, IN 47546-2641 - Phone
- (812) 996-7810
- NPI assigned
- Jul 8, 2024
- Last updated
- Jul 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11023894A | IN | Primary |
Addresses
Primary practice location
966 Bartley St
Jasper, IN 47546-2641
Mailing address
515B W 9TH St
Jasper, IN 47546-2712
Phone (330) 809-7882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240715001924 | IN | Order and Referring Only - Family Practice | 0042755043 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- onwachukwu1044818@direct.deaconess.com
- onwachukwu34568@direct.mhhcc.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1043056138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515B W 9TH ST",
"city": "JASPER",
"state": "IN",
"postal_code": "475462712",
"telephone_number": "330-809-7882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "966 BARTLEY ST",
"city": "JASPER",
"state": "IN",
"postal_code": "475462641",
"telephone_number": "812-996-7810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWACHUKWU",
"first_name": "OLUCHUKWU",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-08",
"last_updated": "2024-07-08",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11023894A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jasper, IN
- Bernard M Nonte, DC
- Norris & Love Orthopaedic & Sports PC (Norris, Blessinger & Woebkenberg Orthopaedics & Spine)
- Randall Gene Norris, MD
- Chad Michael Nunamaker, DPM
- Deedee Imafortor Nwachukwu, PA-C
- Natalie J O'Connor, FNP
- Rajaie A Obaid, M.D.
- Jennifer Obermeier, OTR
- Sarah J Obermeier
- Jo Ellen Obermeyer, OTR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.