Active NPI
Nicole Iheoma Iwuchukwu, MD
- Internal Medicine Physician
- Baton Rouge, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 90670
- Practice address
- 5000 Hennessy Blvd
Baton Rouge, LA 70808 - Phone
- (225) 765-4050
- NPI assigned
- Apr 5, 2016
- Last updated
- Jan 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 90670 | GA | Primary |
Addresses
Primary practice location
5000 Hennessy Blvd
Baton Rouge, LA 70808
Mailing address
5354 Reynolds St
Ste 424
Savannah, GA 31405-6011
Phone (257) 655-7272
Other practice location 1
1501 Kings Hwy
Internal Medicine
Shreveport, LA 71103-4228
Phone (318) 813-2528
Other practice location 2
1501 Kings Hwy
Internal Medicine
Shreveport, LA 71103-4228
Phone (318) 813-2528
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | niwuchukwu801814@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Texas Medical School at San Antonio, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5354 Reynolds St
Suite 424
Savannah, GA 31405-6011
Phone (912) 819-5999
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chatham Hosptialists, LLC | Multi-Specialty | Current | Accepting new patients |
| Candler Hospital Incorporated | Multi-Specialty | Past | Accepting new patients |
Locations
5354 Reynolds St
Ste 424
Savannah, GA 31405
Phone (912) 819-5999
Interoperability endpoints
- niwuchukwu801814@direct.casso.us.com
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Savannah, GA
- NPI 1275527889
Multi-Specialty
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Savannah, GA
- NPI 1275527889
-
- General Acute Care Hospital
- Savannah, GA
- NPI 1063406684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1114380243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5354 REYNOLDS ST",
"address_2": "STE 424",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314056011",
"telephone_number": "257-655-7272",
"fax_number": "225-765-4278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 HENNESSY BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70808",
"telephone_number": "225-765-4050"
}
],
"practiceLocations": [
{
"address_1": "1501 Kings Hwy",
"address_2": "Internal Medicine",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711034228",
"country_code": "US",
"telephone_number": "318-813-2528",
"fax_number": "318-813-2525",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 Kings Hwy",
"address_2": "Internal Medicine",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711034228",
"country_code": "US",
"telephone_number": "318-813-2528",
"fax_number": "318-813-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IWUCHUKWU",
"first_name": "NICOLE",
"middle_name": "IHEOMA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-05",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "GA",
"license": "90670",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "niwuchukwu801814@direct.casso.us.com",
"affiliation": "N",
"endpointDescription": "FMOLHS-Epic",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "niwuchukwu801814@direct.casso.us.com",
"address_1": "5000 Hennessy Blvd",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "70808",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5000 Hennessy Blvd",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "70808",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Baton Rouge, LA
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- Dominique Ivory
- Tabitha Ivy, LMT
- Nia Iyanu, M.S.
- J and E Medical Transportation. LLC
- J Anthony Stephens MD
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- J Woods Enterprises LLC (Southern Regional Medical Equipment and Supplies)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.