Nkechi Ezirim, M.D

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

Q9345 Issued in TX

Practice address

420 E 6TH St
Odessa, TX 79761-4517

Phone

(432) 582-8757

Fax

(432) 582-8757

NPI assigned

Jul 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, SD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Big Bend Medical Group

  • Surgery Physician
  • Big Spring, TX
  • NPI 1811973282

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Nidus Heathcare Consulting PA

  • Maternal & Fetal Medicine Physician
  • Midland, TX
  • NPI 1023824083
  NPD (past) Authorized official
• Big Bend Medical Group

  • Rural Health Clinic/Center
  • Big Spring, TX
  • NPI 1790592004
  NPD
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1336111962
  NPD

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

{
    "created_epoch": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1396009668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614517",
            "telephone_number": "432-582-8757",
            "fax_number": "432-582-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614517",
            "telephone_number": "432-582-8757",
            "fax_number": "432-582-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIRIM",
        "first_name": "NKECHI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-01",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125058651",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101255661",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q9345",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "Q9345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380846102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380846101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73888770",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200752300A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express LLC
• Eyemart Express, LTD.
• Eyemasters of Texas LTD
• Eyes of Texas, LLP
• Ekene Uchenna Ezeokoli, MMD
• Janelle Taclob Fabia
• Krishlene Fabia
• Maida Faheem, MD
• Faith Steps Counseling PLLC
• Olatunde Ibiyemi Falaiye, MD

• Maternal & Fetal Medicine Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.