Individual provider Active NPI

Okafor Mang Lekwuwa, MD

  • Emergency Medicine Physician
  • Eden, NC
National Provider Identifier
1912942335
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31322 Issued in NC
Practice address
117 E Kings Hwy
Eden, NC 27288-5201
Phone
(336) 623-9711
Fax
(336) 623-7660
NPI assigned
Jun 19, 2006
Last updated
Aug 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31322 NC Primary

Addresses

Primary practice location

117 E Kings Hwy
Eden, NC 27288-5201

Mailing address

117 E Kings Hwy
Eden, NC 27288-5201
Phone (336) 623-9711

Other identifiers 2

IdentifierTypeStateIssuer
4617171MedicaidVA
89128NWMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060929000131 VA Practitioner - Emergency Medicine 9739184508 Reassigns benefits to 1 organization
I20110120000636 NC Practitioner - Emergency Medicine 9739184508 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
NC Emergency Physician Services, PLLC Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Danville Emergency Group LLC Emergency Medicine Past Accepting new patients
Main Line Emergency Med Associates LLC Emergency Medicine Past Accepting new patients
Emergency Physicians of Southern Virginia LLP Emergency Medicine Past Accepting new patients
Danville Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Morehead Memorial Hospital Emergency Medicine Past Accepting new patients
Dan River Emergency Services LLC Emergency Medicine Past Accepting new patients

Locations

117 E Kings Hwy
Eden, NC 27288
Phone (336) 627-6181

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

Organizations & group practices 9

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1912942335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEKWUWA",
        "first_name": "OKAFOR",
        "middle_name": "MANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "31322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4617171",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128NW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

Verify at the official NPI Registry.