NPIMap

Individual provider Active NPI

Chinedu Ifejiagwa, MD

  • Student in an Organized Health Care Education/Training Program
  • Jackson, MS
National Provider Identifier
1124550819
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
764 Lakeland Dr
Jackson, MS 39216-4651
Phone
(601) 984-6800
Fax
(601) 984-6811
NPI assigned
Mar 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

764 Lakeland Dr
Jackson, MS 39216-4651

Mailing address

764 Lakeland Dr
Jackson, MS 39216-4651
Phone (601) 984-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200714002574 MS Practitioner - Family Practice 6901229608 Reassigns benefits to 1 organization
I20210819000659 IA Practitioner - Family PracticePractitioner - Emergency Medicine 6901229608 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical Center-CentervilleGroup PAC ID 9739077652, shared by 4 NPIs, 37 clinicians
Des Moines River Physicians LLCGroup PAC ID 0143549634, 45 clinicians

Practice addresses (Care Compare)

1 Saint Joseph Dr
Centerville, IA 52544-9017
Phone (641) 437-4111

204 N 4TH Ave E
Newton, IA 50208-3135
Phone (641) 792-1273

Hospital & facility affiliations

  • Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032
  • Mercyone Centerville Medical Center Hospital, Centerville, IA, CCN 161377
  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

Merit-based Incentive Payment System (MIPS)

Final score
85.29 of 100Reported as group
Quality
80.31
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center-Centerville CurrentSince Nov 22, 2022 Accepting new patients
Allen Memorial Hospital Corporation Current Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Jul 19, 2021 Accepting new patients
Salahuddin Syed MD PC Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Jul 1, 2021 Accepting new patients
Mercy Medical Center-Centerville CurrentSince Nov 22, 2022 Accepting new patients
Des Moines River Physicians, LLC CurrentSince Aug 1, 2021 Accepting new patients
Mercy Medical Center-Centerville Current Accepting new patients
Des Moines River Physicians, LLC CurrentSince Aug 1, 2021 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Jul 1, 2021 Accepting new patients

Locations

1 Saint Joseph Dr
Centerville, IA 52544
Phone (641) 437-3482

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: cifejiagwa3947705@direct.trinity-health.org

Organizations & group practices 11

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 6

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1124550819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164651",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164651",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFEJIAGWA",
        "first_name": "CHINEDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.