NPIMap

Individual provider Active NPI

Kingsley Uzo Okoroafor, MD

  • Cardiovascular Disease Physician
  • Fayetteville, NC
National Provider Identifier
1346346889
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
200500969 Issued in NC
Practice address
1315 Avon St Ste 103
Fayetteville, NC 28304-4423
Phone
(910) 703-8718
Fax
(910) 703-8721
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 200500969 NC Primary
Internal Medicine Physician 207R00000X 200500969 NC

Addresses

Primary practice location

1315 Avon St Ste 103
Fayetteville, NC 28304-4423

Mailing address

1315 Avon St Ste 103
Fayetteville, NC 28304-4423
Phone (910) 703-8718

Other identifiers 2

IdentifierTypeStateIssuer
200500969OtherNCMEDICAL LICENSE NUMBER
5901175MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050902000622 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6901838598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Howard University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1315 Avon St
Suite 103
Fayetteville, NC 28304-4423
Phone (910) 703-8718

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200500969NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Cardiovascular Center PA Cardiovascular Disease CurrentSince Mar 10, 2011 Accepting new patients

Locations

1315 Avon St
Ste 10
Fayetteville, NC 28304
Phone (910) 703-8718

1207 Walter Reed Rd
Fayetteville, NC 28304
Phone (910) 703-8718

1315 Avon St
#103
Fayetteville, NC 28304
Phone (910) 703-8718

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1346346889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 AVON ST STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-703-8718",
            "fax_number": "910-703-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 AVON ST STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-703-8718",
            "fax_number": "910-703-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOROAFOR",
        "first_name": "KINGSLEY",
        "middle_name": "UZO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200500969",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200500969",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "200500969",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901175",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.