Okey Iloegbunam, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP10673 Issued in AZ

Practice address

1510 E Wagon Wheel LN Ste 110
Fort Mohave, AZ 86426-6698

Phone

(928) 788-3333

Fax

(928) 788-3555

NPI assigned

Sep 14, 2017

Last updated

Mar 17, 2018By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emil H Annabi MD PCGroup PAC ID 0941511109, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emil H Annabi MD PC

  dba Pima Pain Management

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1245635390

  Pain Medicine

  Medicare reassignment Care Compare group NPD
• Tri-State Medical Specialists LLC

  dba TriState Pain Institute

  • Pain Medicine Physician
  • Fort Mohave, AZ
  • NPI 1649598426

  CA

  Medicare reassignment
• Emil H Annabi MD PC

  dba Pima Pain Management

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1750146130
  NPD (past)
• Emil H Annabi MD PC

  dba Pima Pain Management

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1902661390
  NPD (past)

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477072130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10966",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864270966",
            "telephone_number": "928-788-3333",
            "fax_number": "928-788-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E WAGON WHEEL LN STE 110",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864266698",
            "telephone_number": "928-788-3333",
            "fax_number": "928-788-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1987 McCulloch Blvd N Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035770",
            "country_code": "US",
            "telephone_number": "928-788-3333",
            "fax_number": "928-788-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILOEGBUNAM",
        "first_name": "OKEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10673",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10673",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "AP10673",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339857",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.