Elizabeth Okwuni Ezeamaka, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R239673 Issued in MD

Practice address

420 Crain Hwy S Ste 3
Glen Burnie, MD 21061-3657

Phone

(240) 421-0007

NPI assigned

Dec 6, 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

Other names 1

• Elizabeth Okwuni Ezeamaka Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prosper Health and Behavioral Care ServicesGroup PAC ID 1951764471, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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

• Prosper Health and Behavioral Care Services

  • Psychiatry Physician
  • Windsor Mill, MD
  • NPI 1801572722
  Medicare reassignment Care Compare group NPD
• Eazy Minds and Behavioral Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
  • NPI 1497685234
  NPD Authorized official
• Prosper Health and Behavioral Care Services

  • Psychiatry Physician
  • Windsor Mill, MD
  • NPI 1588400030
  NPD (past)

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1174339873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CRAIN HWY S STE 3",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613657",
            "telephone_number": "240-421-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CRAIN HWY S STE 3",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613657",
            "telephone_number": "240-421-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEAMAKA",
        "first_name": "ELIZABETH",
        "middle_name": "OKWUNI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R239673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "EZEAMAKA",
            "middle_name": "OKWUNI",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Evolve Residential, LLC
• Evolve Residential, LLC
• Evolve Residential, LLC
• Exclusively Health & Wellness, Inc.
• Jacques Philippe Exposito, DDS
• Nnenna Ezeocha
• Mofeoluwa Fagbemi, LCSW-C
• Asghar Ali Fakhri, M.D.
• Denise Lynn Falkler, R.N.
• Family Discount Pharmacy

• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.
• 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.