Chinemerem Martlin Emeasoba, MBBS

Primary specialty

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

Practice address

1125 N College Ave # Slot100
Fayetteville, AR 72703-1908

Phone

(479) 713-8310

NPI assigned

Mar 21, 2024

Sex

Female

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1114787363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SW PRISM PATH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727135143",
            "telephone_number": "479-799-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE # SLOT100",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-713-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMEASOBA",
        "first_name": "CHINEMEREM",
        "middle_name": "MARTLIN",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "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": []
}

• Leigh Ann Ellis, DNP
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• Jeffrey Cowan Ellison, MD
• Ahmed Elrefaey
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• Sarah Emison, PHARMD
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• Haley R Endacott, APRN

• Student in an Organized Health Care Education/Training Program in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.