Individual provider Active NPI

Kanayo Ogochukwu

  • Acute Care Clinical Nurse Specialist
  • Omaha, NE
National Provider Identifier
1083580872
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
98786 Issued in NE
Practice address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone
(402) 346-8800
NPI assigned
Oct 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 98786 NE Primary

Addresses

Primary practice location

4101 Woolworth Ave
Omaha, NE 68105-1850

Mailing address

4430 Pacific St
Omaha, NE 68105-1736
Phone (402) 968-5289

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
98786NEMDAcute Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1083580872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 PACIFIC ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051736",
            "telephone_number": "402-968-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-346-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGOCHUKWU",
        "first_name": "KANAYO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "NE",
            "license": "98786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.