Physician Compare National (NPI:1962613497)

HEALTHCARE PROVIDER: CHUKUEMEKA N ODITA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1962613497
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830276849
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080401000645
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ODITA
	Individual professional last name
Provider First Name	CHUKUEMEKA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SOUND INPATIENT PHYSICIANS OF TEXAS I, INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8729133640
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	172
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1453 E BERT KOUNS INDUSTRIAL LOOP
	Group Practice or individual's line 1 address
City	SHREVEPORT
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	711056800
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190086
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHERN LOUISIANA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190041
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTUS HEALTH SHREVEPORT - BOSSIER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	191317
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JACKSON PARISH HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	190050
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BEAUREGARD MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	450035
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ST JOSEPH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1962613497)

HEALTHCARE PROVIDER: CHUKUEMEKA N ODITA M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information