Individual provider Active NPI

Clement U Okinedo, M.D.

  • Internal Medicine Physician
  • Huntsville, AL
National Provider Identifier
1629026455
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00023707 Issued in AL
Practice address
408 Governors Dr SW
Huntsville, AL 35801-5124
Phone
(256) 489-0489
Fax
(256) 489-0506
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00023707 AL Primary

Addresses

Primary practice location

408 Governors Dr SW
Huntsville, AL 35801-5124

Mailing address

PO Box 2705
Huntsville, AL 35804-2705
Phone (256) 341-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20050225000740 AL Practitioner - Internal Medicine 4385697630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

408 Governors Dr SW
Huntsville, AL 35801-5124
Phone (256) 489-0489

Hospital & facility affiliations

  • Huntsville Hospital Homecare Home health agency, Huntsville, AL, CCN 017119
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23707ALMDPharmacist
00023707ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saadat Ansari, MD, LLC Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1629026455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-341-2909",
            "fax_number": "256-973-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015124",
            "telephone_number": "256-489-0489",
            "fax_number": "256-489-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKINEDO",
        "first_name": "CLEMENT",
        "middle_name": "U",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00023707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.