Individual provider Active NPI

Nkechi C. Iroku, B.SC.,M.SC.EDU, ETC.

  • Specialist
  • Springfield Gardens, NY
National Provider Identifier
1063777928
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
12146 Grayson St
Springfield Gardens, NY 11413-1038
Phone
(917) 406-8362
Fax
(718) 527-2386
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

12146 Grayson St
Springfield Gardens, NY 11413-1038

Mailing address

121-46 Grayson Street
Springfield Gardens, NY 11413
Phone (917) 406-8362

Other identifiers 1

IdentifierTypeStateIssuer
0673894MedicaidNY

Other names 1

  • Miss Nkechi C. Iloputaife Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063777928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121-46 GRAYSON STREET",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "11413",
            "telephone_number": "917-406-8362",
            "fax_number": "718-527-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12146 GRAYSON ST",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131038",
            "telephone_number": "917-406-8362",
            "fax_number": "718-527-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IROKU",
        "first_name": "NKECHI",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "B.SC.,M.SC.EDU, ETC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0673894",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NKECHI",
            "last_name": "ILOPUTAIFE",
            "middle_name": "C.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.