Individual provider Active NPI

Stella Ekekwe

  • Family Medicine Physician
  • Phillipsburg, NJ
National Provider Identifier
1346846748
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA092194 Issued in NJ
Practice address
445 Marshall St
Phillipsburg, NJ 08865-2695
Phone
(609) 582-0899
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA092194 NJ Primary

Addresses

Primary practice location

445 Marshall St
Phillipsburg, NJ 08865-2695

Mailing address

8126 Fairfield Manor Way
Richmond, TX 77407-1887
Phone (732) 763-0809

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drezeanya@amazinggracemedical.com

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

State licenses

LicenseStateTypeSpecialty
25MA092194NJMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1346846748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8126 FAIRFIELD MANOR WAY",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071887",
            "telephone_number": "732-763-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MARSHALL ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652695",
            "telephone_number": "609-582-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEKWE",
        "first_name": "STELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA092194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drezeanya@amazinggracemedical.com",
            "affiliation": "N",
            "address_1": "445 Marshall St",
            "city": "Phillipsburg",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088652695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.