Chidinma Theresa Ezidiegwu, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Aiken Regional Medical Centers
302 University Parkway
Aiken, SC 29801

Phone

(803) 842-0436

NPI assigned

Apr 16, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chidinma Theresa Chukwulebe Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1003602103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AIKEN REGIONAL MEDICAL CENTERS",
            "address_2": "302 UNIVERSITY PARKWAY",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29801",
            "telephone_number": "803-842-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AIKEN REGIONAL MEDICAL CENTERS",
            "address_2": "302 UNIVERSITY PARKWAY",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29801",
            "telephone_number": "803-842-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIDIEGWU",
        "first_name": "CHIDINMA",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIDINMA",
            "last_name": "CHUKWULEBE",
            "middle_name": "THERESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Extraordinary Services LLC
• Eye Guys Carolina LLC
• Eye Guys Carolina LLC
• Eye Physicians and Surgeons of Augusta, PC (Eye Guys- Aiken)
• Eyemart Express LLC
• Ugochukwu Stanley Ezidiegwu, M.D.
• Faircloth and Bakeman Partnership (Aiken Augusta Oral & Facial Surgery)
• Elizabeth Ryan Faircloth, P.T.
• Robyn F. Fallaw, M.D.
• Jason T. Fancey, MD

• Student in an Organized Health Care Education/Training Program in Aiken, SC
• Providers in Aiken, SC by specialty
• Student in an Organized Health Care Education/Training Program in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.