NPIMap

Individual provider Active NPI

Victor C Nwazue, M.D.

  • Nephrology Physician
  • Jackson, TN
National Provider Identifier
1861657561
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD47704 Issued in TN
Practice address
2863 Highwy 45 Byp
Jackson, TN 38305-3618
Phone
(731) 422-0213
Fax
(731) 256-7664
NPI assigned
Jul 22, 2008
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD47704 TN Primary

Addresses

Primary practice location

2863 Highwy 45 Byp
Jackson, TN 38305-3618

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3705

Other identifiers 1

IdentifierTypeStateIssuer
VAD000OtherTNFEDERAL UPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000394 TN Practitioner - Nephrology 1254504962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

1893 S Highland Ave
Jackson, TN 38301-7799
Phone (731) 423-5585

22 2ND Ave
Huntingdon, TN 38344-3806
Phone (731) 422-0213

2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

3568 Chere Carol Rd
Humboldt, TN 38343-3639
Phone (731) 664-1375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD47704TNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Nephrology CurrentSince Jun 15, 2016 Accepting new patients
Jackson Clinic PA CurrentSince Jun 15, 2016 Accepting new patients
Music City Inpatient Services PLLC Past Accepting new patients
Apogee Medical Group Tennessee PC PastSince Oct 8, 2023 Accepting new patients

Locations

22 2nd Ave
Huntingdon, TN 38344

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

700 W Forest Ave
Ste 300
Jackson, TN 38301
Phone (731) 422-0330

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

Interoperability endpoints

  • Direct secure messaging: victornwazue@jcpa.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1861657561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-425-5752",
            "fax_number": "731-425-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 HIGHWY 45 BYP",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053618",
            "telephone_number": "731-422-0213",
            "fax_number": "731-256-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3705",
            "fax_number": "419-383-3102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAZUE",
        "first_name": "VICTOR",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "MD47704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL UPIN",
            "identifier": "VAD000",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.