Suburban Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01052094A Issued in IN

Legal business name

SUBURBAN DERMATOLOGY LLC

Practice address

1542 S Dixon Rd
Kokomo, IN 46902-7318

Phone

(317) 418-3227

Fax

(317) 844-5746

NPI assigned

Mar 12, 2012

Last updated

Apr 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Josephine Nkechi Okwechime, MDNPI 1952592156

Title

Owner

Phone

(317) 418-3227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Josephine Nkechi Okwechime, MD

  • Dermatology Physician
  • Kokomo, IN
  • NPI 1952592156
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1528333432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 S DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469027318",
            "telephone_number": "317-418-3227",
            "fax_number": "317-844-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469027318",
            "telephone_number": "317-418-3227",
            "fax_number": "317-844-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "OKWECHIME",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_middle_name": "NKECHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-418-3227",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01052094A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stuber Counseling LLC
• Nicole Lee Stuber
• Spenser Studebaker, PT
• Lisa D Stults, FNP
• David Biford Sturgeon, D.D.S.
• Abbee R Summers, PTA
• Whitney Sutherlin
• Nichole J. Suvar, COTA
• Erica Danielle Swaim, COTA/L
• Hayley Swain

• Dermatology Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.