Active NPI
Phillip Ikwuakam
- Home Health Agency
- Columbus, OH
National Provider Identifier
1427478122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2279679
- Practice address
- 4651 Grandover Dr
Columbus, OH 43207-8764 - Phone
- (614) 599-3830
- NPI assigned
- Apr 21, 2014
- Last updated
- Apr 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2279679 | OH | Primary |
Addresses
Primary practice location
4651 Grandover Dr
Columbus, OH 43207-8764
Mailing address
4651 Grandover Dr
Columbus, OH 43207-8764
Phone (614) 599-3830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2279679 | Other | OH | OHIO SECRETARY OF STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2279679 | OH | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1427478122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4651 GRANDOVER DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432078764",
"telephone_number": "614-599-3830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4651 GRANDOVER DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432078764",
"telephone_number": "614-599-3830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKWUAKAM",
"first_name": "PHILLIP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "2279679",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO SECRETARY OF STATE",
"identifier": "2279679",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.