Individual provider Active NPI

Nancy Nkemjika Okeke, DDS

  • Prosthodontics
  • Kenosha, WI
National Provider Identifier
1497060354
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
1002172 Issued in WI
Practice address
7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone
(718) 543-7283
NPI assigned
Aug 16, 2010
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 1002172 WI Primary

Addresses

Primary practice location

7117 Green Bay Rd
Kenosha, WI 53142-1450

Mailing address

7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone (802) 750-1917

Other names 1

  • Mrs. Nancy Okeke Emelogu Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010000968 WI Order and Referring Only - DentistPractitioner - DentistPractitioner - Other (Physician) 4385975051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002172WIMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
David Eidman DDS PC Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1497060354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421450",
            "telephone_number": "802-750-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421450",
            "telephone_number": "718-543-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEKE",
        "first_name": "NANCY",
        "middle_name": "NKEMJIKA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "1002172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "EMELOGU",
            "middle_name": "OKEKE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.