Nwabueze Nnamdi Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L12712R Issued in LA

Legal business name

NWABUEZE NNAMDI INC

Doing business as

East Feliciana Primary Care Clinic

Practice address

3050 Charles Dr
Jackson, LA 70748-6135

Phone

(225) 634-3517

Fax

(225) 635-5057

NPI assigned

Mar 29, 2007

Last updated

Jul 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stacie N Nwabueze, PH.DNPI 1619353406

Title

Administrator

Phone

(225) 634-3517

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EAST FELICIANA PRIMARY CARE CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nnamdi Andrew Nwabueze, M.D.

  • Internal Medicine Physician
  • Jackson, LA
  • NPI 1871525667
  Medicare reassignment NPD
• Stacie Nwabueze, PHD

  • Rehabilitation Practitioner
  • Jackson, LA
  • NPI 1619353406
  NPD Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1114047735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 CHARLES DR",
            "city": "JACKSON",
            "state": "LA",
            "postal_code": "707486135",
            "telephone_number": "225-634-3517",
            "fax_number": "225-635-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 CHARLES DR",
            "city": "JACKSON",
            "state": "LA",
            "postal_code": "707486135",
            "telephone_number": "225-634-3517",
            "fax_number": "225-635-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NWABUEZE NNAMDI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "NWABUEZE",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-634-3517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "L12712R",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "L12712R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1552232",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330241",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST FELICIANA PRIMARY CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Kiamco Mendoza Jr., M.D.
• Jamie Miller
• Schicka Mitchell, GSW
• Monroe and Maggie House, LLC
• Darlene Ngo
• Nnamdi Andrew Nwabueze, M.D.
• Stacie Nwabueze, PHD
• Gabriel I Onor Sr., MD
• Robert William Papcsy III, FNP-C
• Waylon Morris Parker, MD

• Internal Medicine Physician in Jackson, LA
• Providers in Jackson, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.