Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ivan Che Ndamukong, PHD, PA-C

Individual provider Physician Assistant · NPI 1679234371

Ivan Che Ndamukong, PHD, PA-C is a Physician Assistant in Portsmouth, Virginia. Qualified in 2022, 4 years ago. Practices with Roanoke Chowan Community Health Center Inc, a 35-clinician group. Licensed in Virginia.

Years since qualifying
4
Licensed in
VA
In the registry since
2022
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1040 University Blvd Ste 205
Portsmouth, VA 23703-2650
Phone: (757) 391-7370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008765 (VA)

Record details

NPI number1679234371
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , PA-C
Sole proprietorYes
NPI enumeratedJanuary 4, 2022
Last updated in NPPESAugust 29, 2022
Certification dateAugust 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Roanoke Chowan Community Health Center Inc — 35 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

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