Active NPI
Odira Ngozi Okereke, MD
- Family Medicine Physician
- Clovis, CA
National Provider Identifier
1982768412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A88906
- Practice address
- 275 W Herndon Ave
Clovis, CA 93612-0204 - Phone
- (559) 324-6200
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A88906 | CA | Primary |
Addresses
Primary practice location
275 W Herndon Ave
Clovis, CA 93612-0204
Mailing address
8679 N Whitney Ave
Fresno, CA 93720-3940
Phone (559) 325-9846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A88906 | Other | CA | MEDICAL 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88906 | CA | MD | Marriage & Family Therapist |
| A88906 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1982768412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8679 N WHITNEY AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203940",
"telephone_number": "559-325-9846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120204",
"telephone_number": "559-324-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKEREKE",
"first_name": "ODIRA",
"middle_name": "NGOZI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A88906",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "A88906",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.