Nnamdi Kenechukwu Ifediora, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-3965 Issued in AR

Practice address

414 E 9TH St
7
Little Rock, AR 72202-6402

Phone

(870) 718-1236

NPI assigned

Jul 8, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1215249156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E 9TH ST",
            "address_2": "7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722026402",
            "telephone_number": "870-718-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E 9TH ST",
            "address_2": "7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722026402",
            "telephone_number": "870-718-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFEDIORA",
        "first_name": "NNAMDI",
        "middle_name": "KENECHUKWU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-3965",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E3965",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "E-3965",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.