Chuck G Nwakanma

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

01067430A Issued in IN

Practice address

2200 Randallia Dr.
Fort Wayne, IN 46805-4738

Phone

(260) 373-6315

Fax

(260) 373-6348

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Dr. Chukwuemeka G Nwakanma Other name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Critical Care (Intensivists)Also: Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cnwakanma1155103@direct.trinity-health.org

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.

• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment Care Compare group NPD
• La Porte Clinic Company LLC

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187
  NPD (past)

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

• La Porte Hospital Company LLC

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1417984063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E. DUPONT RD.",
            "address_2": "SUITE 3",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-9728",
            "fax_number": "260-373-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054738",
            "telephone_number": "260-373-6315",
            "fax_number": "260-373-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAKANMA",
        "first_name": "CHUCK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036-104042",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301082608",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2006015249",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01067430A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000635990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000772101",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200962220",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "P00803485",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUKWUEMEKA",
            "last_name": "NWAKANMA",
            "middle_name": "G",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amirummul B Nusairee, MD
• Abaigale Nussbaum, RN
• Nicholas Lee Nussbaum, M.D.
• Kloie Nutt, DO
• Nuvena Vein Center, LLC
• Joyce I. Nwakanma, NP
• Hnin Nway, NP
• Ugoeze Jennifer Nwokedi, M.D.
• Seth Noel Nye, DDS, MS
• Timothy Andrew Nye, D.D.S

• Critical Care Medicine (Internal Medicine) Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Critical Care Medicine (Internal Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.