Eze Clinic P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

28175 Issued in TN

Legal business name

EZE CLINIC P.C.

Practice address

2777 N Highland Ave
Jackson, TN 38305-1740

Phone

(731) 661-0067

Fax

(731) 661-0533

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Sarah Eze

Title

Administrator

Phone

(731) 661-0067

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gift Egbon Eze, M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1457384588
  Medicare reassignment NPD
• Jennifer Lee Dawson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1710959283
  NPD (past)
• Charles E. Ewoh, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1114994621
  NPD (past)
• Angie Michelle Whitehurst, CFNP

  • Nurse Practitioner
  • Iuka, MS
  • NPI 1285741884
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1144253279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051740",
            "telephone_number": "731-661-0067",
            "fax_number": "731-661-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051740",
            "telephone_number": "731-661-0067",
            "fax_number": "731-661-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "EZE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "731-661-0067"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "28175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Executive Outcomes PC
• Extendicare of West Tenn
• Extendicare of West TN
• Eye Care Group, PLLC
• Eyemart Express LLC
• Gift Egbon Eze, M.D.
• Katlyn Fahlbeck, RBT
• Erin Elizabeth Fain, NP-C
• Joshua Fainsod, MD
• Faith Health Center

• Internal Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.