Active NPI
Okolocha Medical Corporation
- Family Nurse Practitioner
- Gary, IN
National Provider Identifier
1588016752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71004976
- Legal business name
- OKOLOCHA MEDICAL CORPORATION
- Practice address
- 2054 Grant St
Gary, IN 46404-3060 - Phone
- (219) 949-7540
- Fax
- (219) 949-7545
- NPI assigned
- Jul 12, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Okolocha, MD
- Title
- Owner
- Phone
- (219) 949-7540
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71004976 | IN | Primary |
Addresses
Primary practice location
2054 Grant St
Gary, IN 46404-3060
Mailing address
2054 Grant St
Gary, IN 46404-3060
Phone (219) 949-7540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201272350 | Medicaid | IN |
National Provider Directory
National Provider Directory- Tax ID family
- Okolocha Medical Corp
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Gary, IN
- NPI 1902851330
-
- Family Medicine Physician
- East Chicago, IN
- NPI 1922053354
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Gary, IN
- NPI 1629193321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468281600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468281600000",
"number": "1588016752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2054 GRANT ST",
"city": "GARY",
"state": "IN",
"postal_code": "464043060",
"telephone_number": "219-949-7540",
"fax_number": "219-949-7545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2054 GRANT ST",
"city": "GARY",
"state": "IN",
"postal_code": "464043060",
"telephone_number": "219-949-7540",
"fax_number": "219-949-7545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OKOLOCHA MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2016-07-12",
"last_updated": "2016-07-12",
"status": "A",
"authorized_official_last_name": "OKOLOCHA",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "219-949-7540",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71004976",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201272350",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.