Individual provider Active NPI

Ihuoma N Nwachukwu, MD

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1629062419
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA06248800 Issued in NJ
Practice address
155 Jefferson Street
Newark, NJ 07105-1706
Phone
(973) 589-1300
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA06248800 NJ Primary
Internal Medicine Physician 207R00000X 25MA06248800 NJ
General Practice Physician 208D00000X 25MA06248800 NJ

Addresses

Primary practice location

155 Jefferson Street
Newark, NJ 07105-1706

Mailing address

66 West Gilbert Street
Red Bank, NJ 07701-4918
Phone (732) 212-0060

Other identifiers 3

IdentifierTypeStateIssuer
6948308MedicaidNJ
P00652890OtherNJRAILROAD MEDICARE
01000040103OtherNJAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06248800NJMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essex Emergency Associates, P.a. Emergency Medicine Past Accepting new patients
Premium Medical Care 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1629062419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT STREET",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077014918",
            "telephone_number": "732-212-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 JEFFERSON STREET",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051706",
            "telephone_number": "973-589-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWACHUKWU",
        "first_name": "IHUOMA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA06248800",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06248800",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA06248800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6948308",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00652890",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "01000040103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.