Adesuwa Tracy Egharevba, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4312 District Dr
Raleigh, NC 27699-7708

Phone

(919) 743-9000

NPI assigned

Aug 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• NC Ocme

  • Clinical Medical Laboratory
  • Raleigh, NC
  • NPI 1801270053
  NPD (past)

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306192836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 17TH ST NW, UNIT 5008",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 DISTRICT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276997708",
            "telephone_number": "919-743-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Harry Hines Blvd",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357708",
            "country_code": "US",
            "telephone_number": "214-590-8058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGHAREVBA",
        "first_name": "ADESUWA",
        "middle_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany A Edyburn, MA CCC-SLP
• Effective Therapy Consultants,PA.LLC
• Anne Marie Egan, AUD
• Olivia Egbert
• Sallie Ratcliffe Eggleston, CRC, LCMHC
• Emma Ehlen, LCMHCA
• Kurt J Ehlert, M.D.
• Caitlyn Ehly
• Dominee Ehrhardt, NP
• Susan Ann Ehrlich, LCSW

• Student in an Organized Health Care Education/Training Program in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.