Individual provider Active NPI

Ijeoma Obiageli Nwokenna, B.PHARM

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Victorville, CA
National Provider Identifier
1073996492
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
66071 Issued in CA
Practice address
14829 7TH St Ste E
Victorville, CA 92395-4009
Phone
(760) 245-3518
Fax
(760) 245-1662
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66071 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 66071 CA Primary

Addresses

Primary practice location

14829 7TH St Ste E
Victorville, CA 92395-4009

Mailing address

14829 7TH St Ste E
Victorville, CA 92395-4009
Phone (760) 245-3518

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

State licenses

LicenseStateTypeSpecialty
66071CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Adokiye Enterprises Past Accepting new patients

Organizations & group practices 1

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1073996492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14829 7TH ST STE E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954009",
            "telephone_number": "760-245-3518",
            "fax_number": "760-245-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14829 7TH ST STE E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954009",
            "telephone_number": "760-245-3518",
            "fax_number": "760-245-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOKENNA",
        "first_name": "IJEOMA",
        "middle_name": "OBIAGELI",
        "credential": "B.PHARM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66071",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "66071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.