Individual provider Active NPI

Obinna Chukwuka Akubukwe, PHARM D

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1972807998
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S019109 Issued in AZ
Practice address
6006 S. Central Avenue
Phoenix, AZ 85042
Phone
(602) 276-5485
Fax
(602) 276-0485
NPI assigned
Jan 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302033566 MI
Pharmacist 183500000X S019109 AZ Primary

Addresses

Primary practice location

6006 S. Central Avenue
Phoenix, AZ 85042

Mailing address

6006 S. Central Avenue
Phoenix, AZ 85042
Phone (602) 276-5485

Other identifiers 1

IdentifierTypeStateIssuer
5302033566OtherMIRPH LICENSE

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

LicenseStateTypeSpecialty
S019109AZMDPharmacist
5302033566MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Family Pharmacy PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1972807998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 S. CENTRAL AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85042",
            "telephone_number": "602-276-5485",
            "fax_number": "602-276-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 S. CENTRAL AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85042",
            "telephone_number": "602-276-5485",
            "fax_number": "602-276-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKUBUKWE",
        "first_name": "OBINNA",
        "middle_name": "CHUKWUKA",
        "name_prefix": "Mr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-05",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302033566",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH LICENSE",
            "identifier": "5302033566",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.