NPIMap

Individual provider Active NPI

Jerome Nwanna Nwokike, M.D.

  • Child & Adolescent Psychiatry Physician
  • North Las Vegas, NV
National Provider Identifier
1346225794
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D0059285 Issued in MD
Practice address
5105 Camino Al Norte
North Las Vegas, NV 89031-2373
Phone
(702) 750-2438
Fax
(702) 750-2173
NPI assigned
Dec 8, 2005
Last updated
Jul 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X D0059285 MD
Psychiatry Physician 2084P0800X D0059285 MD
Child & Adolescent Psychiatry Physician 2084P0804X D0059285 MD Primary

Addresses

Primary practice location

5105 Camino Al Norte
North Las Vegas, NV 89031-2373

Mailing address

P.O.Box 371531
Las Vegas, NV 89137
Phone (702) 750-2438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000199 NV Practitioner - Psychiatry 7618983917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frontier Medical and Behavioral Center IncGroup PAC ID 4183912017, 5 clinicians

Practice addresses (Care Compare)

5105 Camino Al Norte
Suite 100
N Las Vegas, NV 89031-2373
Phone (702) 750-2438

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0059285MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Medical & Behavioral Center Inc Forensic Psychiatry CurrentSince Oct 1, 2016 Accepting new patients
Oases Institute of Health Inc Forensic Psychiatry Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Maria K Nwokikemd Face PC PastSince Oct 1, 2016 Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Locations

5105 Camino Al Norte
Ste 100
North Las Vegas, NV 89031
Phone (702) 750-2438

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1346225794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 371531",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89137",
            "telephone_number": "702-750-2438",
            "fax_number": "702-750-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 CAMINO AL NORTE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312373",
            "telephone_number": "702-750-2438",
            "fax_number": "702-750-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOKIKE",
        "first_name": "JEROME",
        "middle_name": "NWANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MD",
            "license": "D0059285",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0059285",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0059285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.