Osita Victor Ezeakudo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01065437A Issued in IN

Practice address

2510 E Dupont Rd
Suite 200
Fort Wayne, IN 46825-1601

Phone

(260) 432-4913

Fax

(260) 969-6832

NPI assigned

Dec 12, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEIADD/Endpoint/BEIADD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1013078351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251675",
            "telephone_number": "260-432-4400",
            "fax_number": "260-969-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E DUPONT RD",
            "address_2": "SUITE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251601",
            "telephone_number": "260-432-4913",
            "fax_number": "260-969-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEAKUDO",
        "first_name": "OSITA",
        "middle_name": "VICTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01065437A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200910310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyecare Express
• Eyecare Express
• Eyemart Express LLC
• Eyemart Express, LTD.
• Ez Medical Supplies LLC
• Patricia Oghogho Ezeakudo
• Fab Mental Health Counseling LLC
• Jessica Fabian
• Jean M Fabini, NP
• Ellen Catherine Fagan-Pryor, MSN, PMHCNS, RN

• Pediatrics Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.