Individual provider Active NPI

Kofi W Nuako, M.D.

  • Gastroenterology Physician
  • Union City, TN
National Provider Identifier
1104813153
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD31272 Issued in TN
Practice address
1109 E Reelfoot Ave
Suite C
Union City, TN 38261-5856
Phone
(731) 884-0600
Fax
(731) 885-6171
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD31272 TN Primary

Addresses

Primary practice location

1109 E Reelfoot Ave
Suite C
Union City, TN 38261-5856

Mailing address

1109 E Reelfoot Ave
Suite C
Union City, TN 38261-5866
Phone (731) 884-0600

Other identifiers 6

IdentifierTypeStateIssuer
148083OtherTNBETTER HEALTH PLANS
3723214MedicaidTN
4073439OtherTNBC/BS
0910401OtherKYADMINISTAR
64721699OtherKYKENTUCKY MEDICAID
28633OtherTNTLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040212000700 TN Practitioner - Gastroenterology 9436042371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kofi Nuako MD PCGroup PAC ID 0446143374, 4 clinicians

Practice addresses (Care Compare)

1109 E Reelfoot Ave C
Union City, TN 38261-5866
Phone (731) 884-0600

Hospital & facility affiliations

  • Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130
  • Volunteer Community Hospital Hospital, Martin, TN, CCN 440061
  • Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072
  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
92.41
Improvement activities
40
Cost
72.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy626
Upper gastrointestinal (GI) endoscopy for acid reflux511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD31272TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union City ASC LLC CurrentSince Jan 1, 2004 Accepting new patients
Kofi Nuako, MD, PC Gastroenterology CurrentSince Jan 3, 2004 Accepting new patients
Kentenn Anesthesia PastSince May 1, 2012 Accepting new patients

Locations

2000 Holiday Ln
Fulton, KY 42041
Phone (270) 472-2522

164 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-5900

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

1109 E Reelfoot Ave
Ste C
Union City, TN 38261
Phone (731) 884-0600

1109 E Reelfoot Ave
Union City, TN 38261
Phone (336) 821-4183

Organizations & group practices 3

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 5

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1104813153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE",
            "address_2": "SUITE C",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615866",
            "telephone_number": "731-884-0600",
            "fax_number": "731-885-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE",
            "address_2": "SUITE C",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615856",
            "telephone_number": "731-884-0600",
            "fax_number": "731-885-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUAKO",
        "first_name": "KOFI",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD31272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BETTER HEALTH PLANS",
            "identifier": "148083",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723214",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4073439",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "0910401",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "64721699",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "28633",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.