Ivan Nwaogu

Primary specialty

PharmacistTaxonomy code 183500000X

License

00007746 Issued in NM

Practice address

2528 Fallbrook Way
Las Cruces, NM 88011-4296

Phone

(443) 854-4727

NPI assigned

Jul 16, 2014

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 names 1

• N/a N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evershine Care, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Las Cruces, NM
  • NPI 1043688088
  NPD Authorized official
• Evershine Care LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Las Cruces, NM
  • NPI 1427775584
  Authorized official Same address or phone
• Evershine Care LLC

  • Mental Illness Intermediate Care Facility
  • Las Cruces, NM
  • NPI 1902393564
  Authorized official Same address or phone

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1285041731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2528 FALLBROOK WAY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114296",
            "telephone_number": "443-854-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 FALLBROOK WAY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114296",
            "telephone_number": "443-854-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAOGU",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "00007746",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "51338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Martin Alonso Nunez, CASE MANAGER
• Samara Nunez
• Magan Rain Nunn
• John Nussbaumer
• Chukwuyejulumafor Nwanze, M.D.
• Onyinyechi Nwosu
• Michael Scott Nystul, PH.D
• Diana O'Brien
• Kim S. O'Connell-Brock, ATC
• Michael Jeffrey O'Connell, CFNP

• Pharmacist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Pharmacist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.