Ikenna E Obasi, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

63230 Issued in MN

Practice address

1811 Weir Dr Ste 270
Woodbury, MN 55125-6741

Phone

(651) 714-9646

Fax

(651) 714-9647

NPI assigned

May 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, NC, MN, GA, IL, WA6 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ikennaobasi@tdh.allscriptsdirect.net

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• County of Lake

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• Critical Care Medical Management Associates PLLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Sleepy Hollow, NY
  • NPI 1194090878

  NC

  Medicare reassignment NPD
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Kalamazoo County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kalamazoo, MI
  • NPI 1710066253
  Medicare reassignment NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• My Therapy Doctor LLC

  • Psychiatry Physician
  • Columbus, GA
  • NPI 1568249845
  Medicare reassignment NPD
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Medicare reassignment NPD
• Veeone Medical Group II Professional Corporation

  • Critical Care Medicine (Internal Medicine) Physician
  • Roseville, CA
  • NPI 1043928443

  NC

  Medicare reassignment NPD
• Veeone Medical Group PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Roseville, CA
  • NPI 1265156558

  NC

  Medicare reassignment NPD
• Healing Holistic Hub PLLC

  • Psychiatry Physician
  • High Point, NC
  • NPI 1225804990
  NPD Authorized official

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1750649455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036785",
            "telephone_number": "715-848-4454",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 WEIR DR STE 270",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551256741",
            "telephone_number": "651-714-9646",
            "fax_number": "651-714-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBASI",
        "first_name": "IKENNA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "56761",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "56761",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "63230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "56761",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan O'Malley, PA-C
• Jessica Susanne O'Mara, PT
• Eleanor Elizabeth O'Neil, LICSW
• Annie O'Neill
• Thomas Walter O'Neill, MA.
• Janel Oberg, LADC, LPCC
• OBGYN Consultants
• Robert Wayne Odegaard, LADC
• Stephanie Odegard, MA
• Andrew Joseph Odhiambo

• Psychiatry Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.