Nicholas Kemdi Ihenacho, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

038149 Issued in GA

Practice address

5329 Memorial Dr
Suite a
Stone Mountain, GA 30083-3212

Phone

(404) 296-7695

Fax

(404) 296-7696

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Veritas Dialysis Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Stone Mountain, GA
  • NPI 1063807634
  NPD
• Georgia Department of Human Resources

  • Psychiatric Hospital
  • Columbus, GA
  • NPI 1144224767
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1477599314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870828",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300870021",
            "telephone_number": "404-296-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 MEMORIAL DR",
            "address_2": "SUITE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833212",
            "telephone_number": "404-296-7695",
            "fax_number": "404-296-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHENACHO",
        "first_name": "NICHOLAS",
        "middle_name": "KEMDI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "038149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000727108D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Kikanwa Ibude, RN
• Ican Think Positive Counseling and Coaching Services
• Benjamin Akpocha Idiale, LDO
• Osarhieme C Igbinoba Okojie, RPH
• Christian Junior Igiede
• Independent Physical Therapy, LLC
• Information Resource Inc
• Innovative Therapy Services
• Inpowerment Incorporated
• Insight Therapy, PC

• Nephrology Physician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.