Active NPI
Obianuju Ezugworie
- Pharmacist
- Shepherdsville, KY
National Provider Identifier
1174190193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 021991
- Practice address
- 152 N Buckman St
Shepherdsville, KY 40165-5900 - Phone
- (502) 543-2202
- NPI assigned
- Jun 8, 2021
- Last updated
- Jun 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 021991 | KY | Primary |
Addresses
Primary practice location
152 N Buckman St
Shepherdsville, KY 40165-5900
Mailing address
152 N Buckman St
Shepherdsville, KY 40165-5900
Phone (502) 543-2202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021991 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
152 N Buckman St
Shepherdsville, KY 40165
Phone (502) 492-0049
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1174190193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 N BUCKMAN ST",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401655900",
"telephone_number": "502-543-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 N BUCKMAN ST",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401655900",
"telephone_number": "502-543-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZUGWORIE",
"first_name": "OBIANUJU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "021991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.