NPIMap

Individual provider Active NPI

Ifeanyichukwu D,C Onukogu, MD

  • Hematology & Oncology Physician
  • Lubbock, TX
National Provider Identifier
1386136794
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
V2804 Issued in TX
Practice address
4101 22ND PL
Lubbock, TX 79410-1121
Phone
(806) 725-8000
NPI assigned
May 31, 2018
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 123456 NY
Internal Medicine Physician 207R00000X 0101281680 VA
Hematology & Oncology Physician 207RH0003X V2804 TX Primary

Addresses

Primary practice location

4101 22ND PL
Lubbock, TX 79410-1121

Mailing address

651 N 5TH St
Newark, NJ 07107-2601
Phone (862) 588-9381

Other practice location 1

1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-5000

Other practice location 2

180 Friendship St Apt 213
Providence, RI 02903-3728
Phone (862) 588-9381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240529002588 VA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7214379767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

104 Carolina Ave
Brookneal, VA 24528-2643
Phone (434) 376-2325

1280 Main St a
Altavista, VA 24517-1465
Phone (434) 309-1165

1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone (434) 200-4522

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

3300 Rivermont Ave
Lynchburg, VA 24503-2030
Phone (434) 200-5999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123456NYMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince May 1, 2024 Accepting new patients
Centra Health Professional Services, LLC Past Accepting new patients

Locations

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1701 Thomson Dr
Ste 200
Lynchburg, VA 24501
Phone (434) 200-5925

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

Organizations & group practices 2

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 10

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1386136794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 N 5TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072601",
            "telephone_number": "862-588-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101121",
            "telephone_number": "806-725-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Friendship St Apt 213",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029033728",
            "country_code": "US",
            "telephone_number": "862-588-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUKOGU",
        "first_name": "IFEANYICHUKWU",
        "middle_name": "D,C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "123456",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101281680",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "V2804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.