Individual provider Active NPI

Chika Lillian Ojukwu, O.D

  • Optometrist
  • Waldorf, MD
National Provider Identifier
1790872752
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1860 Issued in MD
Practice address
122 Smallwood Village Ctr
Waldorf, MD 20602-1843
Phone
(240) 419-3846
Fax
(240) 419-3854
NPI assigned
Oct 9, 2006
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1860 MD Primary

Addresses

Primary practice location

122 Smallwood Village Ctr
Waldorf, MD 20602-1843

Mailing address

122 Smallwood Village Ctr
Waldorf, MD 20602-1843
Phone (240) 419-3846

Other names 1

  • Dr. Chika Lillian Akabogu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110614000535 MD Practitioner - Optometry 6204013576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1860MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chika Eye Care LLC Optometrist CurrentSince Jun 1, 2010 Accepting new patients

Locations

11930 Acton Ln
Waldorf, MD 20601
Phone (240) 435-4822

122 Smallwood Village Ctr
Waldorf, MD 20602
Phone (240) 419-3846

Organizations & group practices 1

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1790872752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SMALLWOOD VILLAGE CTR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021843",
            "telephone_number": "240-419-3846",
            "fax_number": "240-419-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SMALLWOOD VILLAGE CTR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021843",
            "telephone_number": "240-419-3846",
            "fax_number": "240-419-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "CHIKA",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIKA",
            "last_name": "AKABOGU",
            "middle_name": "LILLIAN",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.