Individual provider Active NPI

Blessing Akudo Ibezim, NP

  • Family Nurse Practitioner
  • North Chili, NY
National Provider Identifier
1174914964
Registry record updated Feb 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339147 Issued in NY
Practice address
37 Gilead Hill Rd
North Chili, NY 14514-1239
Phone
(585) 729-5363
NPI assigned
Feb 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339147 NY Primary

Addresses

Primary practice location

37 Gilead Hill Rd
North Chili, NY 14514-1239

Mailing address

37 Gilead Hill Rd
North Chili, NY 14514-1239
Phone (585) 729-5363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160303000735 NY Practitioner - Nurse Practitioner 4981912904 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Urgent Care Center LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

2968 Chili Ave
Rochester, NY 14624
Phone (585) 207-0088

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423958400000",
    "number": "1174914964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 GILEAD HILL RD",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145141239",
            "telephone_number": "585-729-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 GILEAD HILL RD",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145141239",
            "telephone_number": "585-729-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBEZIM",
        "first_name": "BLESSING",
        "middle_name": "AKUDO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-15",
        "last_updated": "2015-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chili, NY

Sources for this page

Verify at the official NPI Registry.