Isidore Obinna Nwagwu, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-75487-021 Issued in KS

Practice address

200 E Centennial Dr
# 3&4
Pittsburg, KS 66762-6571

Phone

(620) 231-9873

Fax

(620) 231-5062

NPI assigned

Dec 28, 2011

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: isidore.nwagwu@khindirect.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.

• Olathe Health Physicians, Inc.

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1598784639
  Medicare reassignment
• Mercy Clinic Pittsburg LLC

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1912751884

  Nurse Practitioner

  NPD
• Freeman-Oak Hill Health System

  dba Freeman Physician Group

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023
  NPD (past)

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376812818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E CENTENNIAL DR",
            "address_2": "# 3&4",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626571",
            "telephone_number": "620-231-9873",
            "fax_number": "620-231-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CENTENNIAL DR",
            "address_2": "# 3&4",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626571",
            "telephone_number": "620-231-9873",
            "fax_number": "620-231-5062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "# 1 Medical Center Circle",
            "address_2": "Ste. A",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "KS",
            "postal_code": "667626613",
            "country_code": "US",
            "telephone_number": "620-235-7605",
            "fax_number": "620-235-7609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAGWU",
        "first_name": "ISIDORE",
        "middle_name": "OBINNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2011039961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-75487-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201071080A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Noble, RN
• Kent R. Noble, LSCSW
• Michael Noble
• Dana Noe, RDH
• Alicia Michelle Norton, PHARM D
• Vicki Ann O'Brien, LCP
• Zoe Ellen O'Dell, LPC
• Rodney K. Odgers, M.D.
• Lauren Oehlert
• Tobi Ohara, PTA

• Family Nurse Practitioner in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.