Individual provider Active NPI

Kingsley C Okonkwo, M.D.

  • Pediatrics Physician
  • Odessa, TX
National Provider Identifier
1982732178
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P4362 Issued in TX
Practice address
912 E 5TH St
Odessa, TX 79761-4605
Phone
(432) 334-8845
Fax
(432) 334-8875
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P4362 TX Primary
Urgent Care Clinic/Center 261QU0200X P4362 TX
Pediatric Cardiology Physician 2080P0202X 4301093606 MI

Addresses

Primary practice location

912 E 5TH St
Odessa, TX 79761-4605

Mailing address

912 E 5TH St
Odessa, TX 79761-4605
Phone (432) 334-8845

Other practice location 1

2101 N Midland Dr Ste 14A
Midland, TX 79707-5507
Phone (432) 695-6035

Other practice location 2

6326 Yorktown Blvd Ste 1B
Corpus Christi, TX 78414-5861
Phone (361) 334-0613

Other practice location 3

6326 Yorktown Blvd Ste 1A
Corpus Christi, TX 78414-5861
Phone (361) 334-0613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 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
I20100929001556 NM Practitioner - Pediatric Medicine 2860518578 Reassigns benefits to 2 organizations
I20151118001200 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2860518578 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093606MIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital CurrentSince Aug 3, 2024 Accepting new patients
Nueces Emergency Medicine Associates PA CurrentSince Feb 1, 2017 Accepting new patients
Roswell Clinic Corp CurrentSince Feb 1, 2020 Accepting new patients
St Vincent Hospital Current Accepting new patients
Dallas Physician Medical Services for Children Inc Pediatrics Current Accepting new patients
Dallas Physician Medical Services for Children Inc Pediatrics CurrentSince Apr 1, 2021 Accepting new patients
Roswell Clinic Corp Family Medicine CurrentSince Feb 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Sing Dy Uy,MD Clinic PA Past Accepting new patients
Pedicare Childrens Urgent Care PA Pediatrics PastSince Nov 1, 2019 Accepting new patients
Roswell Hospital Corporation Past Accepting new patients
Pedicare Childrens Clinic PA Pediatrics PastSince Feb 14, 2021 Accepting new patients

Locations

601 W Country Club Rd
Ste 101
Roswell, NM 88201
Phone (575) 622-8170

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Interoperability endpoints

  • Direct secure messaging: k.okonkwo@pedicare.directbygreenway.com
  • Direct secure messaging: kokonkwo165406@christushealth.direct-ci.net

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1982732178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 E 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614605",
            "telephone_number": "432-334-8845",
            "fax_number": "432-334-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 E 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614605",
            "telephone_number": "432-334-8845",
            "fax_number": "432-334-8875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 N Midland Dr Ste 14A",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797075507",
            "country_code": "US",
            "telephone_number": "432-695-6035",
            "fax_number": "361-214-2983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6326 Yorktown Blvd Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784145861",
            "country_code": "US",
            "telephone_number": "361-334-0613",
            "fax_number": "361-334-0374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6326 Yorktown Blvd Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784145861",
            "country_code": "US",
            "telephone_number": "361-334-0613",
            "fax_number": "361-334-0374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "KINGSLEY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P4362",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "TX",
            "license": "P4362",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301093606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.