DR. NOWOGHOMWENMA CHARLES IBIE (NPI# 1073742953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073742953 |
| Entity Type | Individual |
| Full Name | DR. NOWOGHOMWENMA CHARLES IBIE |
| Credential | MD |
| Practice Address |
207 Haven Dr Dothan AL 36301-2919 |
| Practice Telephone | 3347933319 |
| Practice Fax Number | 3347932291 |
| Mailing Telephone | 3347933319 |
| Mailing Fax Number | 3347932291 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2017-03-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD.30540 | AL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 30540 | AL | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD.30540 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | VIVA HEALTH | Z14079 | 01 |
| AL | BCBS | 511-12500 | 01 |
| AL | TRICARE SOUTH | 1073742953 | 01 |
| AL | 125314 | 05 |
| Street Address |
207 HAVEN DR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-2919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366403255 | Sam Carroll West | Psychiatry & Neurology | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-03-30 |
| 1013551811 | Elizabeth Ann Mcfarland | Nurse Practitioner | 207 Haven Dr, Dothan, AL 36301-2919 | 2019-11-05 |
| 1033517719 | Stefanie L. Kincey | Registered Nurse | 207 Haven Dr, Dothan, AL 36301-2919 | 2014-12-12 |
| 1619264520 | Chanetta Lashan Woodham | Nurse Practitioner | 207 Haven Dr, Dothan, AL 36301-2919 | 2011-06-30 |
| 1083807424 | Linda Hetrick | Licensed Practical Nurse | 207 Haven Dr, Dothan, AL 36301-2919 | 2007-08-20 |
| 1649462292 | Sarah Helms | Registered Nurse | 207 Haven Dr, Dothan, AL 36301-2919 | 2007-08-16 |
| 1861684862 | Judy West | Registered Nurse | 207 Haven Dr, Dothan, AL 36301-2919 | 2007-08-14 |
| 1215082136 | Billy Steve Coker | Counselor | 207 Haven Dr, Dothan, AL 36301-2919 | 2007-01-23 |
| 1104916329 | Jerome Nicholas Hire | Social Worker | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-10-16 |
| 1669567608 | Melissa Holman | Registered Nurse | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013998491 | Olawale Mayokun Osunsanya | Internal Medicine | 1763 E Main St, Dothan, AL 36301-3045 | 2005-11-10 |
| 1386730059 | Ganjur H Guru-prakash | Internal Medicine | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-10-04 |
| 1063526663 | Renal Hypertension Clinic | Internal Medicine | 1540 E Main St, Dothan, AL 36301-3012 | 2006-08-19 |
| 1043267917 | Venkat R Nimmagadda | Internal Medicine | 1540 E Main St, Dothan, AL 36301-3012 | 2006-05-27 |
| 1053361576 | Ravindranath V. Kantamneni | Internal Medicine | 1540 E Main St, Dothan, AL 36301-3012 | 2006-05-12 |
| 1265494181 | Gregory Matthew Wells | Internal Medicine | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154742278 | James Askew | Internal Medicine | 7708 Mountbatten Rd Ne, Tuscaloosa, AL 35406-1146 | 2013-12-16 |
| 1548690571 | Sloan Kidney Services LLC | Internal Medicine | 104 Lowes Blvd, Rainbow City, AL 35906-3132 | 2013-11-12 |
| 1407192172 | Nephrology Medical Associates of Georgia, LLC | Internal Medicine | 3570 Grandview Pkwy Ste 2, Birmingham, AL 35243-2064 | 2012-12-27 |
| 1851649669 | Saad Mohammed Shariff | Internal Medicine | 1900 University Blvd, Tht 643, Birmingham, AL 35294 | 2012-08-28 |
| 1851690069 | Lifeline Vascular Birmingham, Inc | Internal Medicine | 201 London Pkwy, Suite 500, Birmingham, AL 35211-6304 | 2011-03-28 |
| 1750511432 | Uninibile O Odama | Internal Medicine | 210 North Street W, Suite D, Landmark Nephrology and Hypertension Clinic, Talladega, AL 35160 | 2009-07-16 |
| 1154587897 | Mamatha Gandhi | Internal Medicine | 3570 Grandview Pkwy Ste 101, Birmingham, AL 35243-2065 | 2008-08-01 |
| 1902078405 | Azita Takeshian Md PC | Internal Medicine | 100 Pilot Medical Dr Ste 275, Birmingham, AL 35235-3475 | 2008-03-25 |
| 1629264510 | Rameshkumar Athippalayam Chellamuthu | Internal Medicine | 1026 Goodyear Ave Ste 302b, Gadsden, AL 35903-1102 | 2007-09-24 |
| 1457564601 | Roman A Shingarev | Internal Medicine | 61919th St S, Birmingham, AL 35249-0001 | 2007-05-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. NOWOGHOMWENMA CHARLES IBIE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.