Organization Active NPI

Hode Internal Medicine, PLLC

  • Internal Medicine Physician
  • Weatherford, TX
National Provider Identifier
1417370057
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HODE INTERNAL MEDICINE, PLLC
Practice address
730 East Eureka Street
Weatherford, TX 76086-6546
Phone
(682) 582-2989
Fax
(682) 268-2137
NPI assigned
Feb 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Dr. Henry O Ejere, MDNPI 1851595698
Title
Owner
Phone
(682) 582-2989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

730 East Eureka Street
Weatherford, TX 76086-6546

Mailing address

730 East Eureka Street
Weatherford, TX 76086-6546
Phone (682) 582-2989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100915001242 TX Part B Supplier - Clinic/Group Practice 6002931912 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Weatherford, TX

National Provider Directory

National Provider Directory

Locations

730 Eureka St
Weatherford, TX 76086
Phone (682) 582-2989

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1417370057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 EAST EUREKA STREET",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866546",
            "telephone_number": "682-582-2989",
            "fax_number": "682-268-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 EAST EUREKA STREET",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866546",
            "telephone_number": "682-582-2989",
            "fax_number": "682-268-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODE INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "EJERE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-582-2989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.