Ikechukwu C Chidomere

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

Practice address

16731 Beechnut St Apt 206
Houston, TX 77083-6642

Phone

(281) 902-8410

NPI assigned

Nov 14, 2019

Last updated

Nov 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1871138776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16731 BEECHNUT ST APT 206",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836642",
            "telephone_number": "281-902-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16731 BEECHNUT ST APT 206",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836642",
            "telephone_number": "281-902-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDOMERE",
        "first_name": "IKECHUKWU",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U92586271",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chidinmaenterprise LLC (Amourr Care Activity Day Center)
• Samuel Chukwudi Chidoka, PHYSICIAN ASSISTANT
• Stella Chidoka, RN
• Felicia Chidolue, NP
• Chibuike Chidomere
• Mabel Uju Chidozie
• Amarachi Chiamaka Chidume
• Ifeanyi Hyacinth Chiedu
• Stephanie Chiedu, REGISTERED NURSE
• Kevin Chieh

• Adult Development & Aging Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Adult Development & Aging Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.