Individual provider Active NPI

Henry O Nwazuruokeh, DO

  • Family Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1104487891
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102207106 Issued in VA
Practice address
2613 Taylor Rd
Chesapeake, VA 23321-2246
Phone
(757) 738-1600
Fax
(757) 465-8616
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102207106 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2613 Taylor Rd
Chesapeake, VA 23321-2246

Mailing address

755 Memorial Pkwy Ste 300
Phillipsburg, NJ 08865-2748
Phone (908) 847-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220801001010 VA Practitioner - Family Practice 7416339940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Hampton Roads Primary Care LLCGroup PAC ID 0941632756, 62 clinicians

Practice addresses (Care Compare)

2613 Taylor Rd
Suite 201
Chesapeake, VA 23321-2246
Phone (757) 738-1600

3537 Airline Blvd
Suite 1
Portsmouth, VA 23701-2650
Phone (757) 738-1225

Hospital & facility affiliations

  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Bon Secours Harbour View Medical Center Hospital, Suffolk, VA, CCN 490148

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Primary Care LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

2613 Taylor Rd
Ste 201
Chesapeake, VA 23321
Phone (757) 738-1600

155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350

3537 Airline Blvd
Ste 1
Portsmouth, VA 23701
Phone (757) 738-1225

Interoperability endpoints

  • Direct secure messaging: hnwazuruokeh1278651@direct.bsmhealth.org

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.

Hospital & facility affiliations 10

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1104487891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY STE 300",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-847-3300",
            "fax_number": "908-847-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 TAYLOR RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233212246",
            "telephone_number": "757-738-1600",
            "fax_number": "757-465-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAZURUOKEH",
        "first_name": "HENRY",
        "middle_name": "O",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207106",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.