Ifeoma Juliet Ezeigwe, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP133917 Issued in TX

Practice address

601 Beechwood Dr
Tyler, TX 75701-7735

Phone

(903) 593-1246

Fax

(903) 593-1246

NPI assigned

Mar 14, 2018

Last updated

Dec 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Groups Recover Together Texas PAGroup PAC ID 3072952035, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Groups Recover Together (Texas), P.a.

  dba Groups Recover Together

  • Adult Mental Health Clinic/Center
  • Tyler, TX
  • NPI 1679288963

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1104329218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BEECHWOOD DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017735",
            "telephone_number": "903-593-1246",
            "fax_number": "903-593-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BEECHWOOD DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017735",
            "telephone_number": "903-593-1246",
            "fax_number": "903-593-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEIGWE",
        "first_name": "IFEOMA",
        "middle_name": "JULIET",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP133917",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP133917",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP133917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express, LTD.
• Eyemasters of Texas, LTD (EyeMasters)
• Chinedu James Ezeafulukwe, MD
• Victoria Ezeh
• Anthonia Nkechi Ezeigwe, R.N.
• Lilian Eziefule
• Malak Ezzat, MD
• Robert Immanuel Fabela Jr.
• Omar Antonio Fabian
• Damilola Fabiyi

• Gerontology Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.