Individual provider Active NPI

Ikemefuna Nkanginieme, MD

  • Psychiatry Physician
  • Canton, OH
National Provider Identifier
1972524049
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD418915 Issued in PA
Practice address
4735 Belpar St NW
Canton, OH 44718-3648
Phone
(330) 493-9822
Fax
(330) 493-9816
NPI assigned
Jul 22, 2006
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.078767 OH
Psychiatry Physician 2084P0800X MD418915 PA Primary

Addresses

Primary practice location

4735 Belpar St NW
Canton, OH 44718-3648

Mailing address

4735 Belpar St NW
Canton, OH 44718-3648
Phone (330) 493-9822

Other identifiers 1

IdentifierTypeStateIssuer
2294691MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040917000540 OH Practitioner - PsychiatryPractitioner - Interventional Pain Management 3274501358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4735 Beldar St NW
Canton, OH 44718-3648
Phone (330) 493-9822

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.078767OHMDPsychiatry Physician
MD418915PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizons Psychiatric Counseling and Pain Management Services LLC Psychiatry CurrentSince May 1, 2005 Accepting new patients
Portage Path Behavioral Health Past Accepting new patients
Summit Psychological Associates, Inc. Past Accepting new patients
Portage Path Community Mental Health Center Past Accepting new patients
Portage Path Behavioral Health Past Accepting new patients

Locations

4450 Belden Village St NW
Ste 215
Canton, OH 44718
Phone (330) 493-8337

4735 Belpar St NW
Canton, OH 44718
Phone (330) 417-9552

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/summit-psychological/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1972524049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183648",
            "telephone_number": "330-493-9822",
            "fax_number": "330-493-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183648",
            "telephone_number": "330-493-9822",
            "fax_number": "330-493-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKANGINIEME",
        "first_name": "IKEMEFUNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.078767",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD418915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2294691",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.