Emmanuel Azubuike Nwisu, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12251 Issued in CA

Practice address

101 E Hobsonway Ste C
Blythe, CA 92225-1700

Phone

(760) 922-0446

NPI assigned

Apr 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1208563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208563200000",
    "number": "1558535609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E HOBSONWAY STE C",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251700",
            "telephone_number": "760-922-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E HOBSONWAY STE C",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251700",
            "telephone_number": "760-922-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWISU",
        "first_name": "EMMANUEL",
        "middle_name": "AZUBUIKE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-19",
        "last_updated": "2008-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Path Sober Living
• Luna Thanh Ngo, DMD
• Hung Duy Nguyen, RPH
• Tony Tuan Nguyen, PHARM.D
• Morgan Lee Nowlin, DO
• Josephine Adaeze Nwisu
• Guadalupe Contreras Ochoa
• Funmi Olubunmi Olukoya, ARNP, FNP
• Wael Oweity, DDS
• Palo Verde Health Care District (Palo Verde Hospital)

• Medical Physician Assistant in Blythe, CA
• Providers in Blythe, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2008; 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.