Henry Okonkwo

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16806 Issued in CA

Practice address

976 Blackberry LN
Dominguez Hills, CA 90746

Phone

(310) 464-7042

Fax

(310) 756-6500

NPI assigned

Feb 15, 2007

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Health First Physician Assistants Medical Group Inc

  dba G-Tube Specialists

  • Physician Assistant
  • Redondo Beach, CA
  • NPI 1396596763
  Authorized official Same address or phone
• One Health Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Hermosa Beach, CA
  • NPI 1710604616
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1700929841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11041 SANTA MONICA BLVD # 515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253523",
            "telephone_number": "310-464-7042",
            "fax_number": "888-400-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 BLACKBERRY LN",
            "city": "DOMINGUEZ HILLS",
            "state": "CA",
            "postal_code": "90746",
            "telephone_number": "310-464-7042",
            "fax_number": "310-756-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.