Jude Chibuogwu Ejim, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

304136 Issued in AZ

Practice address

2500 E Van Buren St
Phoenix, AZ 85008-6037

Phone

(602) 685-3100

NPI assigned

Mar 18, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1033978655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 N 61ST AVE APT 1073",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853026782",
            "telephone_number": "225-485-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086037",
            "telephone_number": "602-685-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIM",
        "first_name": "JUDE",
        "middle_name": "CHIBUOGWU",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "304136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita W Eisenhart, DO
• Leslie Allan Eisner, M.D.
• Amirarsalan Eissa, M.D.
• Louries Eissa
• Ejecutivos Taxi
• Sandra Denise Ekeinde, PHD
• April Ekeoma
• Queendoline Unyime Ekpo, ANP-BC
• Deepali D Eksambe, M.D
• Brandi Ekstrom, C.O.A., S.T.

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.