Individual provider Active NPI

Obieze Ogbo

  • Student in an Organized Health Care Education/Training Program
  • Las Cruces, NM
National Provider Identifier
1215797352
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
39988521 Issued in TX
Practice address
4311 E Lohman Ave
Las Cruces, NM 88011-8255
Phone
(575) 556-7600
NPI assigned
Mar 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 39988521 TX Primary

Addresses

Primary practice location

4311 E Lohman Ave
Las Cruces, NM 88011-8255

Mailing address

4311 E Lohman Ave
Las Cruces, NM 88011-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20250816000146 MO Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 3274048368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39988521TXMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1215797352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118255",
            "telephone_number": "575-556-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBO",
        "first_name": "OBIEZE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "39988521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.