NPIMap

Individual provider Active NPI

Odinaka Joseph Nnanna, MD

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1083036917
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2014-0008 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 724-6124
Fax
(505) 724-6125
NPI assigned
Jan 13, 2014
Last updated
Mar 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2014-0008 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 1

IdentifierTypeStateIssuer
22436529MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626001076 NM Practitioner - Internal Medicine 7214152792 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uka Healthcare Services LLCGroup PAC ID 1355724303, 7 clinicians
Amber Horizon Longterm Care PCGroup PAC ID 2961917950, 6 clinicians

Practice addresses (Care Compare)

1740 Grande Blvd SE
Suite E 10
Rio Rancho, NM 87124-1799
Phone (505) 504-1147

919 Mesa Roja TRL NE
Rio Rancho, NM 87124-6388
Phone (505) 504-1147

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Partners CurrentSince Apr 23, 2018 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jul 14, 2014 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 1, 2021 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jul 14, 2014 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 1, 2021 Accepting new patients
Amber Horizon Longterm Care PC CurrentSince Feb 19, 2026 Accepting new patients
Uka Healthcare Services LLC Internal Medicine CurrentSince Jun 3, 2022 Accepting new patients
Clearsky Rehabilitation Hospital of Rio Rancho LLC Past Accepting new patients
Cabezon Nursing and Rehab Center LLC Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

4550 Eubank Blvd NE
Ste 107
Albuquerque, NM 87111
Phone (505) 332-1006

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1740 Grande Blvd SE
Ste 10
Rio Rancho, NM 87124
Phone (505) 504-1147

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Suites Rio VistaRio Rancho, NM, CCN 325127 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 15, 2024
Jan 15, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1083036917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-724-6124",
            "fax_number": "505-724-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNANNA",
        "first_name": "ODINAKA",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-13",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2014-0008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22436529",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.