NPIMap

Individual provider Active NPI

John Okechukwu Nwora, MD

  • Internal Medicine Physician
  • Caruthersville, MO
National Provider Identifier
1760596563
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
106331 Issued in MO
Practice address
1117 Ward Ave
Caruthersville, MO 63830-2622
Phone
(573) 333-4441
Fax
(573) 333-5142
NPI assigned
Aug 18, 2006
Last updated
Jul 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 106331 MO Primary

Addresses

Primary practice location

1117 Ward Ave
Caruthersville, MO 63830-2622

Mailing address

PO Box 200
1117 Ward Ave
Caruthersville, MO 63830-0200
Phone (573) 333-4441

Other identifiers 1

IdentifierTypeStateIssuer
207679200MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050224000327 MO Practitioner - Family Practice 4981657467 Practice locations: Caruthersville, MO

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dexter Emergency Physicians, LLC Past Accepting new patients
Twin Rivers Emergency Physicians, LLC Past Accepting new patients
Pemiscot County Memorial Hospital Past Accepting new patients
Pemiscot County Memorial Hospital Past Accepting new patients
Kennett Emergency Physicians Past Accepting new patients
Missouri Em-I Medical Services, PC Past Accepting new patients
Callaway Emergency Physicians, LLC Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1760596563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "address_2": "1117 WARD AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638300200",
            "telephone_number": "573-333-4441",
            "fax_number": "573-333-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 WARD AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302622",
            "telephone_number": "573-333-4441",
            "fax_number": "573-333-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWORA",
        "first_name": "JOHN",
        "middle_name": "OKECHUKWU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "106331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207679200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caruthersville, MO

Sources for this page

Verify at the official NPI Registry.