Active NPI
Kemnasom Nwanwene
- Hematology & Oncology Physician
- Lubbock, TX
National Provider Identifier
1861053969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- V5807
- Practice address
- 4101 22ND PL
Lubbock, TX 79410-1121 - Phone
- (806) 725-8000
- Fax
- (806) 723-6031
- NPI assigned
- Jun 28, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hematology & Oncology Physician | 207RH0003X | V5807 | TX | Primary |
Addresses
Primary practice location
4101 22ND PL
Lubbock, TX 79410-1121
Mailing address
2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5228
Other practice location 1
1249 15th St
Huntington, WV 25701-3662
Phone (304) 691-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250729001010 | TX | Practitioner - Hematology/Oncology | 6204343874 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Medical Group
Practice addresses (Care Compare)
4101 22ND PL
Lubbock, TX 79410-1121
Phone (806) 725-8000
Hospital & facility affiliations
- Covenant Childrens Hospital
- Covenant Medical Center
- Cabell Huntington Hospital, Inc
- Nor-Lea Hospital District
- Providence Portland Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group | Current | Accepting new patients | |
| Covenant Medical Group | Current | Accepting new patients |
Locations
4101 22nd Pl
Lubbock, TX 79410
Phone (806) 725-8000
2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228
Interoperability endpoints
- knwanwene3820439@oc.providencedirect.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.
-
- Rural Health Clinic/Center
- Abernathy, TX
- NPI 1538412895
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
Hospital
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1861053969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 NASHVILLE AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101105",
"telephone_number": "806-725-5228",
"fax_number": "806-723-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 22ND PL",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101121",
"telephone_number": "806-725-8000",
"fax_number": "806-723-6031"
}
],
"practiceLocations": [
{
"address_1": "1249 15th St",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "WV",
"postal_code": "257013662",
"country_code": "US",
"telephone_number": "304-691-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NWANWENE",
"first_name": "KEMNASOM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2025-07-30",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TX",
"license": "V5807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.