Individual provider Active NPI

Obiageri Thelma Ekeh, MD

  • Pediatric Critical Care Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1518083872
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
13139 Issued in NV
Practice address
2040 W Charleston Blvd
402
Las Vegas, NV 89102-2227
Phone
(702) 671-2345
Fax
(702) 671-2233
NPI assigned
Mar 21, 2007
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13139 NV
Pediatric Critical Care Medicine Physician 2080P0203X 13139 NV Primary

Addresses

Primary practice location

2040 W Charleston Blvd
402
Las Vegas, NV 89102-2227

Mailing address

1701 W Charleston Blvd
215
Las Vegas, NV 89102-2325
Phone (702) 671-2355

Other identifiers 1

IdentifierTypeStateIssuer
100500484 GROUPMedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20090917000505 NV Practitioner - Pediatric Medicine 9830245737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Pokroy Medical Group of Nevada LTDGroup PAC ID 7911037643, 19 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8000

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (702) 233-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13139NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pokroy Medical Group of Nevada, LTD. Pediatrics CurrentSince Nov 21, 2018 Accepting new patients
Unsom Multi-Spec GRP Pract S Family Medicine Past Accepting new patients
University of NV School of Medicine Multi Specialty Group Practice So Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1518083872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD",
            "address_2": "215",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022325",
            "telephone_number": "702-671-2355",
            "fax_number": "702-382-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W CHARLESTON BLVD",
            "address_2": "402",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022227",
            "telephone_number": "702-671-2345",
            "fax_number": "702-671-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEH",
        "first_name": "OBIAGERI",
        "middle_name": "THELMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "13139",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NV",
            "license": "13139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500484 GROUP",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.