Individual provider Active NPI

Ugonma Christiana Nwaohuocha, O.D

  • Optometrist
  • Colonial Heights, VA
National Provider Identifier
1760618763
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002277 Issued in VA
Practice address
671 Southpark Blvd
Colonial Heights, VA 23834-3617
Phone
(804) 520-4390
Fax
(804) 520-4391
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007385 NY
Optometrist 152W00000X 0618002277 VA Primary

Addresses

Primary practice location

671 Southpark Blvd
Colonial Heights, VA 23834-3617

Mailing address

2757 Seymour Ave
Bronx, NY 10469-5523
Phone (718) 427-6861

Other identifiers 2

IdentifierTypeStateIssuer
1033470539MedicaidVA
03136032MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140623000689 VA Practitioner - Optometry 9537212089 Reassigns benefits to 1 organization
Practice locations: Powhatan, VA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Legacy Eye CareGroup PAC ID 7214185057, 2 clinicians

Practice addresses (Care Compare)

1950 Anderson Hwy
Powhatan, VA 23139-7918
Phone (804) 379-0555

671 Southpark Blvd
Colonial Heights, VA 23834-3617
Phone (804) 520-4390

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007385NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Eye Care Optometrist CurrentSince Apr 5, 2014 Accepting new patients
Dr N Optometrist PastSince Oct 28, 2019 Accepting new patients

Locations

671 Southpark Blvd
Colonial Hgts, VA 23834
Phone (804) 520-4390

3500 S Crater Rd
Petersburg, VA 23805
Phone (804) 861-2020

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.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1760618763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 SEYMOUR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695523",
            "telephone_number": "718-427-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 SOUTHPARK BLVD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343617",
            "telephone_number": "804-520-4390",
            "fax_number": "804-520-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAOHUOCHA",
        "first_name": "UGONMA",
        "middle_name": "CHRISTIANA",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007385",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033470539",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03136032",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.