Kaodichinma Ogbonna

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704267833 Issued in MI

Practice address

6071 W Outer Dr
Detroit, MI 48235-2624

Phone

(313) 966-1400

NPI assigned

Jan 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pioneer Medical Group PLLCGroup PAC ID 5092075598, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pioneer Medical Group PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1801304688
  Medicare reassignment Care Compare group NPD
• A Ahmad MD PLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1306313515
  Medicare reassignment NPD
• Unified Academic Physicians PC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1689537102
  Medicare reassignment NPD

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1972076693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18362 CEDAR ISLAND BLVD",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481749584",
            "telephone_number": "313-646-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBONNA",
        "first_name": "KAODICHINMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704267833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yemisi Odetoyinbo, LMSW
• Odicare PC
• Tanya Odisho, D.O.
• Iesha Odum, MS, CAADC, LPC
• Ama Ofosu-Appiah, DDS
• Doris D Ogburn, RDH
• Kamdili Nnadebem Ogbutor
• Herbert Luke Ogden, MD
• Oboseh John Ogedegbe
• Tamarandobra Ogeh, MD

• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.