Individual provider Active NPI

Nnanna Ekeoma, FNP

  • Family Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1336654722
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08170586 Issued in NY
Practice address
11515 170TH St
Jamaica, NY 11434-1841
Phone
(516) 754-7078
NPI assigned
Dec 6, 2017
Last updated
Dec 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08170586 NY Primary

Addresses

Primary practice location

11515 170TH St
Jamaica, NY 11434-1841

Mailing address

11515 170TH St
Jamaica, NY 11434-1841
Phone (516) 754-7078

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
341111NYMDLicensed Practical Nurse
F08170586NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peyman Younesi MD PLLC Past Accepting new patients

Organizations & group practices 1

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1336654722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 170TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341841",
            "telephone_number": "516-754-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 170TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341841",
            "telephone_number": "516-754-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEOMA",
        "first_name": "NNANNA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F08170586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.