NPIMap

Individual provider Active NPI

Ikechukwu Onyekachi Nwobu

  • Nephrology Physician
  • High Point, NC
National Provider Identifier
1366645848
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2008-00200 Issued in NC
Practice address
4515 Premier Dr
Ste 403
High Point, NC 27265-8357
Phone
(336) 802-2930
Fax
(336) 802-2931
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 200800200 NC
Nephrology Physician 207RN0300X 2008-00200 NC Primary

Addresses

Primary practice location

4515 Premier Dr
Ste 403
High Point, NC 27265-8357

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

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
I20080922000393 NC Practitioner - NephrologyPractitioner - Internal Medicine 5496822157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

4515 Premier Dr
Suite 403
High Point, NC 27265-8356
Phone (336) 802-2930

Hospital & facility affiliations

  • High Point Kidney Center Dialysis facility, High Point, NC, CCN 342514
  • Triad Dialysis Center Dialysis facility, High Point, NC, CCN 342599
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • High Point Regional Health System Hospital, High Point, NC, CCN 340004
  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200800200NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Dec 7, 2013 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Aug 28, 2011 Accepting new patients
KND Development 59 , LLC CurrentSince Dec 7, 2013 Accepting new patients
Wake Forest Health Network LLC Nephrology CurrentSince Aug 28, 2011 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network LLC Past Accepting new patients
Cornerstone Health Care LLC Past Accepting new patients
Every Step Beyond Counseling, PLLC PastSince Mar 19, 2023 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

2401 S Side Blvd
Greensboro, NC 27406
Phone (336) 271-2800

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

4515 Premier Dr
Ste 403
High Point, NC 27265
Phone (336) 802-2930

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Organizations & group practices 11

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 9

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1366645848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR",
            "address_2": "STE 403",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658357",
            "telephone_number": "336-802-2930",
            "fax_number": "336-802-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOBU",
        "first_name": "IKECHUKWU",
        "middle_name": "ONYEKACHI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "200800200",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2008-00200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.