Queendaleen C Chukwurah, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

750 Morphy Ave
Fairhope, AL 36532-1899

Phone

(251) 279-1529

NPI assigned

May 3, 2021

Last updated

May 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hospitalist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Home Health Home health agency, Albany, GA, CCN 117100
• Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: qchukwurah97615@directinfirmaryhealth.org

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  NPD (past)

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

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Home Health

  • Home Health Agency
  • Albany, GA
  • NPI 1790766863
  Care Compare affiliation
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Care Compare affiliation

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1295318756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321899",
            "telephone_number": "251-279-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321899",
            "telephone_number": "251-279-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWURAH",
        "first_name": "QUEENDALEEN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ana.peters@infirmaryhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "750 Morphy Ave",
            "city": "Fairhope",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365321899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ana.peters@infirmaryhealth.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "750 Morphy Ave",
            "city": "Fairhope",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365321899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitzi M Childs, MD
• Richard C Childs, M.D.
• Anne S. Chipman, LMFT
• Kelly Anne Chism, M.S.
• Christine S. Aiken, PHD, LLC
• Michael Clark, P.T.
• Robert Alan Clark, M.D.
• Zachary Kyle Clark, MD
• Christopher Clarke, MD
• Clearlyusa.Com, L.L.C.

• Student in an Organized Health Care Education/Training Program in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Student in an Organized Health Care Education/Training Program in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.