Kelechi Nneka Ndubuizu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2015-00218 Issued in NC

Practice address

111 E 3Rd Ave
Gastonia, NC 28052-4343

Phone

(704) 874-3300

Fax

(704) 874-0065

NPI assigned

May 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Adventist Physician Services, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Gaithersburg, MD
  • NPI 1376623207

  DC

  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1871852822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-867-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524343",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUBUIZU",
        "first_name": "KELECHI",
        "middle_name": "NNEKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2015-00218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald H Nason Jr., D.D.S., M.S.
• National Mentor Healthcare, LLC
• National Vision, Inc.
• Raymond Navarro
• NC Total Solutions LLC
• Demar Austin Neal, M.D., F.A.C.S.
• James E Neal, M.D.
• Richard Grayson Neal, DDS, MS
• Tyesha Harvey Neal, CRNA
• Samuel Needleman

• Family Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.