Active NPI
Kanayochukwu Kanny Jacquelyne Anya, M.D.
- Surgery Physician
- Fort Worth, TX
National Provider Identifier
1821278151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- N9800
- Practice address
- 6048 Lake Worth Blvd
Fort Worth, TX 76135-3706 - Phone
- (817) 270-4243
- Fax
- (817) 270-4249
- NPI assigned
- Nov 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 54922-20 | WI | |
| Surgery Physician | 208600000X | MD204301 | LA | |
| Surgery Physician | 208600000X | N9800 | TX | Primary |
Addresses
Primary practice location
6048 Lake Worth Blvd
Fort Worth, TX 76135-3706
Mailing address
6100 Harris Parkway
Suite 380
Fort Worth, TX 76132
Phone (817) 759-9008
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343872301 | Medicaid | TX | |
| 343872302 | Medicaid | TX |
Other names 1
- Kanayochukwu Kanny Jacquelyne Aluka
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD204301 | LA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501804800000",
"number": "1821278151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 HARRIS PARKWAY",
"address_2": "SUITE 380",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76132",
"telephone_number": "817-759-9008",
"fax_number": "844-583-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6048 LAKE WORTH BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761353706",
"telephone_number": "817-270-4243",
"fax_number": "817-270-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANYA",
"first_name": "KANAYOCHUKWU KANNY",
"middle_name": "JACQUELYNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-03",
"last_updated": "2017-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "54922-20",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "LA",
"license": "MD204301",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "N9800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "343872301",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "343872302",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KANAYOCHUKWU KANNY",
"last_name": "ALUKA",
"middle_name": "JACQUELYNE",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.