Michael Chukwuma Odibo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2015-01360 Issued in NC

Practice address

1215 Medical Center Dr
Wilmington, NC 28401-7306

Phone

(910) 228-5894

Fax

(888) 836-5759

NPI assigned

Apr 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13974/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/IBJFDD/Endpoint/IBJFDD

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.

• Odibo Medical Group PLLC

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1710334503
  Medicare reassignment NPD Authorized official
• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1922022607
  Medicare reassignment NPD
• Sunlight Medical Clinic PLLC

  • Primary Care Clinic/Center
  • Wilmington, NC
  • NPI 1063958890
  NPD (past) Authorized official
• Coastal Horizons Center Inc

  • Community/Behavioral Health Agency
  • Rocky Point, NC
  • NPI 1063082592
  NPD
• Coastal Horizons Center Inc

  • Community/Behavioral Health Agency
  • Shallotte, NC
  • NPI 1952909160
  NPD
• Coastal Horizons Center, Inc

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1033420153
  NPD
• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1790985448
  NPD
• Apogee Medical Group of New Jersey PA

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1104873629
  NPD (past)
• Saline Physician Services, LLC

  • Internal Medicine Physician
  • Bryant, AR
  • NPI 1144559287
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1144496191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017306",
            "telephone_number": "910-228-5894",
            "fax_number": "910-228-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017306",
            "telephone_number": "910-228-5894",
            "fax_number": "888-836-5759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284126431",
            "country_code": "US",
            "telephone_number": "910-202-5709",
            "fax_number": "910-202-9966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODIBO",
        "first_name": "MICHAEL",
        "middle_name": "CHUKWUMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08470600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091533",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "42141",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "251015",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-01360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100061340",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000592390",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000592390",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ocular Prosthetics Inc
• Oculoplastic Consultants of the Carolinas, PLLC
• Patricia A Odham, FNP
• Odibo Medical Group PLLC
• Imelda Ngozi Odibo, MD
• Michelle Chukwuebuka Odibo
• Kiara Odom
• Stephanie Ann Odriscoll
• Oluwole Ademola Odunusi, M.D.
• Alan Edward Oester Jr., M.D.

• Internal Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.

Verify at the official NPI Registry.