Individual provider Active NPI

Kenechim A. Anamekwe, M.D.

  • Internal Medicine Physician
  • Wylie, TX
National Provider Identifier
1891996112
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N7208 Issued in TX
Practice address
500 S Westgate Way
Suite #300
Wylie, TX 75098-5308
Phone
(972) 941-8484
Fax
(972) 941-8480
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N7208 TX Primary

Addresses

Primary practice location

500 S Westgate Way
Suite #300
Wylie, TX 75098-5308

Mailing address

PO Box 1119
Wylie, TX 75098-1119
Phone (972) 941-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110103000129 TX Practitioner - Internal Medicine 0749478048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

500 S Westgate Way
Suite 300
Wylie, TX 75098-5319
Phone (972) 941-8484

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7208TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vivify Wellness Center Internal Medicine CurrentSince Jul 29, 2015 Accepting new patients

Locations

500 S Westgate Way
Ste 300
Wylie, TX 75098
Phone (972) 941-8484

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14636/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kenechim.anamekwe.1@14636.direct.athenahealth.com

Organizations & group practices 1

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1891996112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750981119",
            "telephone_number": "972-941-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S WESTGATE WAY",
            "address_2": "SUITE #300",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750985308",
            "telephone_number": "972-941-8484",
            "fax_number": "972-941-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAMEKWE",
        "first_name": "KENECHIM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

Verify at the official NPI Registry.