Kekelo Medical Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KEKELO MEDICAL INC

Practice address

150 Creekrise Dr
Peachtree City, GA 30269-4801

Phone

(706) 535-1565

Fax

(706) 760-2206

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Noble Iwuagwu, MDNPI 1811004484

Title

Ceo

Phone

(706) 535-1565

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noble Chukwuemeka Iwuagwu, MD

  • Hospitalist Physician
  • Peachtree City, GA
  • NPI 1811004484

  Nephrology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1306310222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CREEKRISE DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694801",
            "telephone_number": "706-535-1565",
            "fax_number": "706-760-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CREEKRISE DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694801",
            "telephone_number": "706-535-1565",
            "fax_number": "706-760-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEKELO MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "IWUAGWU",
        "authorized_official_first_name": "NOBLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-535-1565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Karzin, D.C
• Kathy Wagner Counseling Services LLC
• Linda H Katz, D.C.
• Nicole S Kearney, M.D.
• Lynn Matti Keel, LPCC
• Lauren Christine Keller, CNM
• Kelly Luce Acevedo
• Christal Kelly, FNP-C
• Erica Marie Kennedy, NP
• Hillari Kennedy, DC

• Nephrology Physician in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.