Osahon Nekpen Idolor, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

12725 Issued in GA

Practice address

1625 N Campbell Ave
Tucson, AZ 85719-4330

Phone

(520) 626-4111

NPI assigned

Mar 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Internal MedicineAlso: Rheumatology

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1437529245
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center South Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1558759498
  Care Compare affiliation
• Banner - University Medical Center South Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1922660182

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716681600000",
    "number": "1568048361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-626-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Ajo Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-626-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDOLOR",
        "first_name": "OSAHON",
        "middle_name": "NEKPEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-05-26",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "12725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Lois Icenogle, PHARMACIST
• Carol L. Ickes, P.T.
• Ruru Idahosa, DO
• Ideal Health Services Group Inc
• Ideal Rehabilitation LLC
• Nassim Idouraine
• Nasreldin Idris
• Ies Arizona PLLC
• Ies Obs Arizona PLLC
• Ahmad Iftikhar, MD

• Rheumatology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Rheumatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.