Active NPI
Ikechukwu Stanislaus Iwunnah
- Contractor
- Mesquite, TX
National Provider Identifier
1235463084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 0109451
- Practice address
- 3201 Ih 30 Ste C2
Mesquite, TX 75150-2602 - Phone
- (972) 279-0643
- Fax
- (972) 279-0543
- NPI assigned
- Sep 28, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 0109451 | TX | Primary |
Addresses
Primary practice location
3201 Ih 30 Ste C2
Mesquite, TX 75150-2602
Mailing address
3201 Ih-30 Ste C2
Mesquite, TX 75150-2602
Phone (972) 279-0643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0109451 | TX | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I Devine-Care Medical DME & Supply | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Mesquite, TX
- NPI 1942534516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254096000000",
"number": "1235463084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 IH-30 STE C2",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751502602",
"telephone_number": "972-279-0643",
"fax_number": "972-279-0543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 IH 30 STE C2",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751502602",
"telephone_number": "972-279-0643",
"fax_number": "972-279-0543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWUNNAH",
"first_name": "IKECHUKWU",
"middle_name": "STANISLAUS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-28",
"last_updated": "2009-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "0109451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
- Kashif Irfan, MD
- Chimaobi Vera Iroegbu
- Martina Garcella Isaac, M.A. CCC/SLP
- Parampottil Tharian Issac, TECH
- Troy P Issac, TECH
- Ahmad N Izzat, RHP
- J & M Communications Inc
- J Kirkland Grant, M.D. PA
- J Olivieri Professional Health Network LLC
- J-Lydash Inc Dba Mesquite Adult Day Activities Health Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.