Active NPI
Ugonna Nnodim, PHARM D
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1699042135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP00007764
- Practice address
- 1235 E Charleston Blvd
Las Vegas, NV 89104-1708 - Phone
- (702) 209-3640
- Fax
- (702) 209-3641
- NPI assigned
- Nov 29, 2011
- Last updated
- May 18, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00007764 | NM | Primary |
Addresses
Primary practice location
1235 E Charleston Blvd
Las Vegas, NV 89104-1708
Mailing address
1235 E Charleston Blvd
Las Vegas, NV 89104-1708
Phone (702) 209-3640
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00007764 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Falcon LLC | Current | Accepting new patients |
Locations
1235 E Charleston Blvd
Las Vegas, NV 89104
Phone (702) 209-3640
Organizations & group practices 1
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": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1699042135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 E CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891041708",
"telephone_number": "702-209-3640",
"fax_number": "702-209-3641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 E CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891041708",
"telephone_number": "702-209-3640",
"fax_number": "702-209-3641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NNODIM",
"first_name": "UGONNA",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-29",
"last_updated": "2021-05-18",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00007764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.