NPIMap

Individual provider Active NPI

Ineada Okafor, MD

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1881918522
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14822 Issued in NV
Practice address
871 Coronado Center Dr Ste 141
Henderson, NV 89052-3977
Phone
(702) 566-2400
Fax
(702) 433-2477
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14822 NV Primary

Addresses

Primary practice location

871 Coronado Center Dr Ste 141
Henderson, NV 89052-3977

Mailing address

10001 S Eastern Ave
Suite 310
Henderson, NV 89052-3907

Other identifiers 1

IdentifierTypeStateIssuer
7025662400OtherEMPLOYER

Other names 1

  • Ineada Jack Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14822NVMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hills Medical Center, LLC Past Accepting new patients
Henderson Hospital Past Accepting new patients
Lamotte Pediatrics, LLP Pediatrics Past Accepting new patients
Dignity Health Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1881918522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE",
            "address_2": "SUITE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523907",
            "fax_number": "702-433-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 CORONADO CENTER DR STE 141",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523977",
            "telephone_number": "702-566-2400",
            "fax_number": "702-433-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAFOR",
        "first_name": "INEADA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "14822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER",
            "identifier": "7025662400",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INEADA",
            "last_name": "JACK",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.