Stephanie A Ezebuiro, MD

Key facts

NPI

1013437797

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

MD-46599 (IA)

Practice address

1000 73Rd St Ste 20
West Des Moines, IA 50265-1321

Phone

(515) 223-6794

NPI assigned

Jun 22, 2017

Sex

Female

Sole proprietor

No

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alegent Creighton Clinic Family Medicine Physician · Council Bluffs, IA · NPI 1598811069
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · IA
• Cherokee County Physicians, LLC Emergency Medicine Physician · Centre, AL · NPI 1760958680
  Medicare reassignment Care Compare group NPD AL
• Avera Holy Family Critical Access Hospital · Estherville, IA · NPI 1508810177
  Medicare reassignment NPD IA
• Curana Health of Iowa PLLC Internal Medicine Physician · Osceola, IA · NPI 1730773714
  Medicare reassignment NPD IA
• Waverly Health Center Critical Access Hospital · Waverly, IA · NPI 1447299953
  Medicare reassignment NPD IA
• Waverly Health Center Family Medicine Physician · Waverly, IA · NPI 1598959371
  Medicare reassignment NPD FAMILY MEDICINE · IA
• Chattooga River Physicians, LLC Emergency Medicine Physician · Trion, GA · NPI 1184302473
  Medicare reassignment NPD GA
• Etowah Emergency Physicians, LLC Emergency Medicine Physician · Rome, GA · NPI 1962944900
  Medicare reassignment NPD GA
• Phoebe Sumter Medical Center, Inc. General Acute Care Hospital · Americus, GA · NPI 1609001312
  Medicare reassignment NPD GA
• Phoebe Worth Medical Center, Inc Medicare Defined Swing Bed Hospital Unit · Sylvester, GA · NPI 1760460448
  Medicare reassignment NPD GA
• Weiss Lake Hospitalists, LLC Hospitalist Physician · Centre, AL · NPI 1205397643
  Medicare reassignment NPD AL
• Alegent Creighton Clinic Family Medicine Physician · Omaha, NE · NPI 1548287907
  Care Compare group NPD FAMILY MEDICINE
• Erx Group, LLC Emergency Medicine Physician · Alma, GA · NPI 1760823082
  Medicare reassignment GA
• Waverly Health Center Rural Health Clinic/Center · Janesville, IA · NPI 1184094534
  NPD
• Phoebe Sumter Medical Center, Inc Rural Health Clinic/Center · Ellaville, GA · NPI 1376778001
  NPD
• Phoebe Worth Medical Center, Inc Critical Access Hospital · Sylvester, GA · NPI 1639157431
  NPD

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alegent Health Bergan Mercy Health System General Acute Care Hospital · Council Bluffs, IA · NPI 1265517759
  Care Compare affiliation Hospital
• Shenandoah Medical Center Critical Access Hospital · Shenandoah, IA · NPI 1184621096
  Care Compare affiliation Hospital
• Floyd Cherokee Medical Center LLC General Acute Care Hospital · Centre, AL · NPI 1962999664
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherokee County Physicians LLC (14 clinicians)
Alegent Creighton Clinic (951 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Floyd Cherokee Medical Center Hospital · Centre, AL · CCN 010022
• CHI Health Mercy Council Bluffs Hospital · Council Bluffs, IA · CCN 160028
• Shenandoah Medical Center Hospital · Shenandoah, IA · CCN 161366

Medicare participation

Medicare fee-for-service enrollment

Enrolled (3 enrollments) in IA, GA, AL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: samarachiezebuiro3011496@carolinashealthcaresystem.direct-ci.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Addresses

Other names

• Stephanie A Anyikude Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 14, 2023.

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1013437797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 SE MESA DR",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502631308",
            "telephone_number": "202-558-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 73RD ST STE 20",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502651321",
            "telephone_number": "515-223-6794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Laurel St",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503143024",
            "country_code": "US",
            "telephone_number": "515-612-9595",
            "fax_number": "515-643-4662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZEBUIRO",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-46599",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ANYIKUDE",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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