Active NPI
Chibuikem Henry Ezeasor, PHARMD
- Pharmacist
- Fayetteville, GA
National Provider Identifier
1467908640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH029272
- Practice address
- 215 Brookestone PT
Fayetteville, GA 30215-8241 - Phone
- (678) 860-1129
- NPI assigned
- Aug 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH029272 | GA | Primary |
Addresses
Primary practice location
215 Brookestone PT
Fayetteville, GA 30215-8241
Mailing address
215 Brookestone PT
Fayetteville, GA 30215-8241
Phone (678) 860-1129
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH029272 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1467908640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 BROOKESTONE PT",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302158241",
"telephone_number": "678-860-1129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 BROOKESTONE PT",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302158241",
"telephone_number": "678-860-1129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEASOR",
"first_name": "CHIBUIKEM",
"middle_name": "HENRY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-29",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH029272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.