Active NPI
Olunwa Chisara Ikpeazu, M.D.
- Pediatrics Physician
- Coral Springs, FL
National Provider Identifier
1912047382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 100885
- Practice address
- 9120A Wiles Rd
Coral Springs, FL 33067-1993 - Phone
- (954) 341-0074
- Fax
- (954) 345-3474
- NPI assigned
- Feb 7, 2007
- Last updated
- Sep 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME 100885 | FL | Primary |
Addresses
Primary practice location
9120A Wiles Rd
Coral Springs, FL 33067-1993
Mailing address
6944 NW 126TH Ave
Parkland, FL 33076-1964
Phone (954) 579-2242
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000633700 | Medicaid | FL | |
| 3820581 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME 100885 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Pediatrics | Past | Accepting new patients |
| Saltzman, Tanis, Pittell, Levin and Jacobson | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Pediatric Associates
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
-
dba Pediatric Associates
- Pediatrics Physician
- Coral Springs, FL
- NPI 1316155096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1912047382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6944 NW 126TH AVE",
"city": "PARKLAND",
"state": "FL",
"postal_code": "330761964",
"telephone_number": "954-579-2242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9120A WILES RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330671993",
"telephone_number": "954-341-0074",
"fax_number": "954-345-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKPEAZU",
"first_name": "OLUNWA",
"middle_name": "CHISARA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 100885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000633700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3820581",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.