Individual provider Active NPI

Collins U Ekwenugo, BACHALOR OF SCIENCE

  • Nursing Care Agency
  • Snellville, GA
National Provider Identifier
1265080048
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Practice address
2555 Rosedale Rd
Snellville, GA 30078-4101
Phone
(404) 863-7942
NPI assigned
Aug 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

2555 Rosedale Rd
Snellville, GA 30078-4101

Mailing address

PO Box 464031
Lawrenceville, GA 30042-4031

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

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1265080048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464031",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300424031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 ROSEDALE RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784101",
            "telephone_number": "404-863-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKWENUGO",
        "first_name": "COLLINS",
        "middle_name": "U",
        "credential": "BACHALOR OF SCIENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.