Active NPI
Godson Nzubechi Iheanacho Jr., PHARMD
- Community/Retail Pharmacy
- Cleveland, OH
National Provider Identifier
1831720085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Practice address
- 15322 Saint Clair Ave
Cleveland, OH 44110-3043 - Phone
- (216) 851-1500
- Fax
- (216) 851-0602
- NPI assigned
- Jan 27, 2020
- Last updated
- Sep 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | Community/Retail Pharmacy | Past | Accepting new patients |
| H-E-B, LP | Community/Retail Pharmacy | Past | Accepting new patients |
Interoperability endpoints
- 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, 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": "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.