Kelechi Maduka

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

789766 Issued in TX

Practice address

4229 Glenhaven Dr
Garland, TX 75042-6120

Phone

(469) 209-3783

Fax

(972) 918-5166

NPI assigned

May 13, 2020

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Covenant Home Health LLC

  • Home Health Agency
  • Garland, TX
  • NPI 1467098079
  NPD
• Saint Catherine Hospice Inc.

  • Community Based Hospice Care Agency
  • Garland, TX
  • NPI 1619397932
  NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1710509740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 GLENHAVEN DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426120",
            "telephone_number": "469-209-3783",
            "fax_number": "972-918-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 GLENHAVEN DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426120",
            "telephone_number": "469-209-3783",
            "fax_number": "972-918-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUKA",
        "first_name": "KELECHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "789766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin K Ma, PHARM. D.
• Eva Louise Macaluso, LPC, R.N.
• Caitlin Macdonald, RN
• Andre Alexander Macedon
• James B Maddox, M.D.
• Magecare Health Services, Inc
• Magnolia Dentistry, PLLC
• Sherry Selle Magnus, AU.D.
• Duyen June Magnuson, FNP-BC
• Jacqueline Ann Mahoney

• Administrator Registered Nurse in Garland, TX
• Providers in Garland, TX by specialty
• Administrator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.