Individual provider Active NPI

Chinweoke U Ezekwueche, NP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1235650094
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN194503 Issued in GA
Practice address
550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240
Phone
(404) 872-3121
NPI assigned
Jul 3, 2017
Last updated
Jul 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN194503 GA Primary
Gerontology Nurse Practitioner 363LG0600X RN194503 GA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN194503 GA

Addresses

Primary practice location

550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240

Mailing address

550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240
Phone (404) 872-3119

Other identifiers 2

IdentifierTypeStateIssuer
AG02170149OtherGACERTIFICATION
RN194503OtherGALICENSE

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN194503GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Perinatal Associates CurrentSince Jul 22, 2017 Accepting new patients
Pagemed, LLC Past Accepting new patients

Locations

550 Peachtree St NE
Ste 1275
Atlanta, GA 30308
Phone (404) 872-3121

Interoperability endpoints

  • Direct secure messaging: chinweoke.ezekwueche@perinatalmed.gadirect.net

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1235650094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082240",
            "telephone_number": "404-872-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082240",
            "telephone_number": "404-872-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEKWUECHE",
        "first_name": "CHINWEOKE",
        "middle_name": "U",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN194503",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN194503",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN194503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "AG02170149",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN194503",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.