Active NPI
Kenneth Chijioke Nonyelum, PHARMD
- Pharmacist
- Orlando, FL
National Provider Identifier
1912501461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57888
- Practice address
- 4315 Curry Ford Rd
Orlando, FL 32806-2706 - Phone
- (407) 896-0552
- NPI assigned
- Nov 25, 2020
- Last updated
- Nov 25, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 57888 | FL | Primary |
Addresses
Primary practice location
4315 Curry Ford Rd
Orlando, FL 32806-2706
Mailing address
12336 Great Commission Way
Orlando, FL 32832-7110
Phone (321) 945-4461
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57888 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1912501461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12336 GREAT COMMISSION WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328327110",
"telephone_number": "321-945-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4315 CURRY FORD RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062706",
"telephone_number": "407-896-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NONYELUM",
"first_name": "KENNETH",
"middle_name": "CHIJIOKE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-25",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "57888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.