Kanayo Afamefina Ezeanolue, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

14287 Issued in NV

Practice address

1800 W. Charleston Blvd.
Las Vegas, NV 89102

Phone

(702) 383-2000

Fax

(313) 745-5867

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pediatric Medicine

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbi6007@yourcarecommunity.org
• Direct secure messaging: kezeanolue10419@direct.umcsn.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/3fe59471-3589-4f65-b447-b92822bfc057/

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.

• University Medical Center of Southern Nevada

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1548393127
  Medicare reassignment NPD
• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment
• Pokroy Medical Group of Nevada, LTD.

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412

  Pediatrics

  NPD (past)
• Southern Hills Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1457306359
  NPD (past)
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1104870187
  NPD (past)
• Doctors Hospital at Renaissance, LTD

  • General Acute Care Hospital
  • Edinburg, TX
  • NPI 1053317362
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1215053582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W. CHARLESTON BLVD. STE. 508",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-383-2688",
            "fax_number": "702-671-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W. CHARLESTON BLVD.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-383-2000",
            "fax_number": "313-745-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEANOLUE",
        "first_name": "KANAYO",
        "middle_name": "AFAMEFINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301093717",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NV",
            "license": "14287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bibiana Chioma Ezeanolue, D.M.D
• Chinenye Ezeanolue, MD
• Dolue David Ezeanolue, MD
• Echezona Edozie Ezeanolue, M.D.
• Edozie Ezeanolue, MD
• Ezeanolue, MD, Precision Surgery Center of Las Vegas, PLLC
• Chinazor Thelma Ezeli
• Gillian Ezell
• Layla Nicole Ezell, RBT
• Maya L Ezell

• Neonatal-Perinatal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Neonatal-Perinatal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.