NPIMap

Individual provider Active NPI

Blessing N. Okoronkwo, M.D.

  • Nephrology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1720298136
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301084051 Issued in MI
Practice address
29001 Harper Ave
Saint Clair Shores, MI 48081-2711
Phone
(586) 778-0664
Fax
(586) 778-0396
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301084051 MI
Nephrology Physician 207RN0300X 4301084051 MI Primary

Addresses

Primary practice location

29001 Harper Ave
Saint Clair Shores, MI 48081-2711

Mailing address

29001 Harper Ave
Saint Clair Shores, MI 48081-2711
Phone (586) 778-0664

Other identifiers 1

IdentifierTypeStateIssuer
700E017240OtherMIBCBSM GROUP NUMBER

Other names 1

  • Blessing N. Okoli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080306000269 MI Practitioner - NephrologyPractitioner - Internal Medicine 1052496635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Care Specialists of Michigan PCGroup PAC ID 5597940080, 3 clinicians

Practice addresses (Care Compare)

29001 Harper Ave
Saint Clair Shores, MI 48081-2711
Phone (586) 778-0664

Hospital & facility affiliations

  • FMC Dialysis - Clinton Dialysis facility, Clinton Township, MI, CCN 232554
  • Home Dialysis Specialty Center Dialysis facility, Saint Clair Shores, MI, CCN 232691
  • Dialysis Centers of Michigan Dialysis facility, Eastpointe, MI, CCN 232712
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084051MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Specialists of Michigan PC Nephrology CurrentSince Jul 9, 2012 Accepting new patients
Internal Medicine Specialties PC Internal Medicine Past Accepting new patients

Locations

29001 Harper Ave
St Clr Shores, MI 48081
Phone (586) 778-0664

28111 Hoover Rd
Ste 5A
Warren, MI 48093
Phone (412) 425-4221

Interoperability endpoints

  • Direct secure messaging: bokoronkwo249108@direct.hfhs.org

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 9

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1720298136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812711",
            "telephone_number": "586-778-0664",
            "fax_number": "586-778-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812711",
            "telephone_number": "586-778-0664",
            "fax_number": "586-778-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORONKWO",
        "first_name": "BLESSING",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301084051",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301084051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700E017240",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLESSING",
            "last_name": "OKOLI",
            "middle_name": "N.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.