Active NPI
Shannon Ejiofor, DO
- Nephrology Physician
- El Paso, TX
National Provider Identifier
1285251983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- W0562
- Practice address
- 4801 Alberta Ave
El Paso, TX 79905-2707 - Phone
- (915) 215-5200
- Fax
- (915) 215-8640
- NPI assigned
- Jun 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2020018976 | MO | |
| Nephrology Physician | 207RN0300X | W0562 | TX | Primary |
| Nephrology Physician | 207RN0300X | 2023020723 | MO |
Addresses
Primary practice location
4801 Alberta Ave
El Paso, TX 79905-2707
Mailing address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 257-8000
Other practice location 1
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 257-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, MO, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300
Hospital & facility affiliations
- University Medical Center of El Paso
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023020723 | MO | MD | Nephrology Physician |
| W0562 | TX | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center El Paso | Internal Medicine | Current | Accepting new patients |
| Texas Tech University Health Sciences Center El Paso | Current | Accepting new patients | |
| Texas Tech University Health Sciences Center Odessa | Internal Medicine | Past | Accepting new patients |
Locations
4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- El Paso, TX
- NPI 1598705055
-
- Neurological Surgery Physician
- El Paso, TX
- NPI 1457913444
-
- Family Medicine Physician
- Odessa, TX
- NPI 1407845084
Internal Medicine
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- El Paso, TX
- NPI 1316936990
-
- General Acute Care Hospital
- El Paso, TX
- NPI 1619747938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1285251983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "314-257-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 ALBERTA AVE",
"city": "EL PASO",
"state": "TX",
"postal_code": "799052707",
"telephone_number": "915-215-5200",
"fax_number": "915-215-8640"
}
],
"practiceLocations": [
{
"address_1": "1201 S Grand Blvd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631041016",
"country_code": "US",
"telephone_number": "314-257-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EJIOFOR",
"first_name": "SHANNON",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-29",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2020018976",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "W0562",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MO",
"license": "2023020723",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.