Individual provider Active NPI

Chinyere Okoronkwo, M.D.

  • Pediatrics Physician
  • Vernon, CT
National Provider Identifier
1861770711
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
053238 Issued in CT
Practice address
57 Hartford Tpke
Vernon, CT 06066-5286
Phone
(860) 645-1100
NPI assigned
Jul 26, 2011
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 053238 CT Primary
Pediatric Adolescent Medicine Physician 2080A0000X 053238 CT

Addresses

Primary practice location

57 Hartford Tpke
Vernon, CT 06066-5286

Mailing address

57 Hartford Tpke
Vernon, CT 06066-5286
Phone (860) 645-1100

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 837-7250

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cokoronkwo49639@connecticutchildrens.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141205000316 CT Practitioner - Pediatric Medicine 1951623727 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053238CTMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Connecticut Children's Specialty Group, Inc. Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Prohealth Physicians PC Pediatrics CurrentSince Sep 7, 2018 Accepting new patients
Prospect Manchester Hospital, Inc. Past Accepting new patients

Locations

800 Connecticut Blvd
Fl 1
East Hartford, CT 06108
Phone (800) 535-6232

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

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.

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1861770711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665286",
            "telephone_number": "860-645-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665286",
            "telephone_number": "860-645-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-837-7250",
            "fax_number": "860-837-6970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKORONKWO",
        "first_name": "CHINYERE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "053238",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "053238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cokoronkwo49639@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.