Individual provider Active NPI

Godson Nzubechi Iheanacho Jr., PHARMD

  • Community/Retail Pharmacy
  • Cleveland, OH
National Provider Identifier
1831720085
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Practice address
15322 Saint Clair Ave
Cleveland, OH 44110-3043
Phone
(216) 851-1500
Fax
(216) 851-0602
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

15322 Saint Clair Ave
Cleveland, OH 44110-3043

Mailing address

1257 Webb Rd
Lakewood, OH 44107-2250
Phone (512) 584-0212

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
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP Community/Retail Pharmacy PastSince Feb 1, 2020 Accepting new patients
H-E-B, LP Community/Retail Pharmacy PastSince Feb 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: giheanacho617919@ehrdirect.uhhospitals.org

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1831720085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 WEBB RD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072250",
            "telephone_number": "512-584-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15322 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103043",
            "telephone_number": "216-851-1500",
            "fax_number": "216-851-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEANACHO",
        "first_name": "GODSON",
        "middle_name": "NZUBECHI",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.