Organization Active NPI

Endo 247 LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Memphis, TN
National Provider Identifier
1255953956
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDO 247 LLC
Practice address
5220 Park Ave Ste 202
Memphis, TN 38119-3549
Phone
(901) 744-3362
NPI assigned
May 15, 2020
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Dr. Cherechi C. Ogwo, MDNPI 1720321060
Title
Chief Manager/Provider
Phone
(901) 744-3362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary

Addresses

Primary practice location

5220 Park Ave Ste 202
Memphis, TN 38119-3549

Mailing address

875 W Poplar Ave Ste 23
#102
Collierville, TN 38017-2598
Phone (901) 744-3362

Other identifiers 1

IdentifierTypeStateIssuer
Q057155MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200531000053 TN Part B Supplier - Clinic/Group Practice 7517388556 Receives reassigned benefits from 6 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

875 W Poplar Ave
Ste 23
Collierville, TN 38017

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1255953956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 W POPLAR AVE STE 23",
            "address_2": "#102",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172598",
            "telephone_number": "901-744-3362",
            "fax_number": "901-744-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE STE 202",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193549",
            "telephone_number": "901-744-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDO 247 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "OGWO",
        "authorized_official_first_name": "CHERECHI",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF MANAGER/PROVIDER",
        "authorized_official_telephone_number": "901-744-3362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q057155",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.