Individual provider Active NPI

Chinedu Peter Ezike, CNP

  • Family Nurse Practitioner
  • Mansfield, OH
National Provider Identifier
1477215572
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029920 Issued in OH
Practice address
370 Cline Ave
Mansfield, OH 44907-1057
Phone
(419) 468-0965
Fax
(419) 462-4566
NPI assigned
Oct 6, 2021
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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 APRN.CNP.0029920 OH Primary

Addresses

Primary practice location

370 Cline Ave
Mansfield, OH 44907-1057

Mailing address

PO Box 1086
Willoughby, OH 44096-1086
Phone (216) 645-7242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428001160 OH Practitioner - Nurse Practitioner 1456748086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Incare Health Solutions LLCGroup PAC ID 5092980730, 66 clinicians

Practice addresses (Care Compare)

375 N Lexington Springmill Rd
Ontario, OH 44906-3812
Phone (419) 528-0047

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029920OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions LLC CurrentSince Feb 11, 2023 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Feb 11, 2023 Accepting new patients

Locations

1085 Polaris Pkwy
Columbus, OH 43240
Phone (614) 505-0021

1341 S Trimble Rd
Mansfield, OH 44907
Phone (419) 775-7807

375 N Lexington Springmill Rd
Ontario, OH 44906
Phone (419) 528-0047

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1477215572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440961086",
            "telephone_number": "216-645-7242",
            "fax_number": "440-975-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CLINE AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071057",
            "telephone_number": "419-468-0965",
            "fax_number": "419-462-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIKE",
        "first_name": "CHINEDU",
        "middle_name": "PETER",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.