Chukwukadibia J Odunukwe, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

23714 Issued in OK

Practice address

5604 SW Lee Blvd
Suite 210
Lawton, OK 73505-9681

Phone

(580) 531-6462

Fax

(580) 531-6426

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22682/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/1821/brand/1/csg/22/fhir/r4

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.

• Southwestern Surgical Affiliates, LLC

  • Orthopaedic Surgery Physician
  • Lawton, OK
  • NPI 1013169531
  Medicare reassignment NPD
• Lawton General Surgery PC

  • Surgery Physician
  • Lawton, OK
  • NPI 1508474792
  NPD Authorized official
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• McAlester Physician Management Services

  • Specialist
  • McAlester, OK
  • NPI 1346342151
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1992778831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8679",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158679",
            "telephone_number": "580-531-6465",
            "fax_number": "580-531-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 SW LEE BLVD",
            "address_2": "SUITE 210",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059681",
            "telephone_number": "580-531-6462",
            "fax_number": "580-531-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUNUKWE",
        "first_name": "CHUKWUKADIBIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "23714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123714",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00769476",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Obrien
• Ocean Dental, PC
• Jackie Jene Odell-Miller, ARNP
• Tammy J Odell, SLP
• Deborah Jean Odom, LBP
• Madison Odvody, RBT
• Stephen Kwame Ofori-Kwakye, MD
• Annabelle Ogden
• Lametrice Oglesby
• Okc Dental Health Associates, P.C. (MyDentist-Lawton)

• Surgery Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.