Individual provider Active NPI

Lilian Nkiru Ndukwe, MSN, FNP

  • Primary Care Nurse Practitioner
  • Carson, CA
National Provider Identifier
1750710950
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
21943 Issued in CA
Practice address
454 E Carson Plaza Dr
Suite 209
Carson, CA 90746-3209
Phone
(310) 965-6550
Fax
(310) 965-6552
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 21943 CA Primary

Addresses

Primary practice location

454 E Carson Plaza Dr
Suite 209
Carson, CA 90746-3209

Mailing address

454 E Carson Plaza Dr
Suite 209
Carson, CA 90746-3209
Phone (310) 965-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220422002287 CA Practitioner - Nurse Practitioner 3274622865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone (213) 699-7013

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21943CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 21, 2021 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Dec 21, 2021 Accepting new patients
Carepointe Home Health Services, Inc. Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

2829 S Grand Ave
Los Angeles, CA 90007
Phone (213) 699-7000

Interoperability endpoints

  • Direct secure messaging: lndukwe@landmarkhealth-direct.org

Organizations & group practices 4

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 1

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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1750710950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 E CARSON PLAZA DR",
            "address_2": "SUITE 209",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463209",
            "telephone_number": "310-965-6550",
            "fax_number": "310-965-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 E CARSON PLAZA DR",
            "address_2": "SUITE 209",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463209",
            "telephone_number": "310-965-6550",
            "fax_number": "310-965-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUKWE",
        "first_name": "LILIAN",
        "middle_name": "NKIRU",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "21943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.