Individual provider Active NPI

Ekom Nnamdie, ARNP

  • Family Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1568889335
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9203060 Issued in FL
Practice address
20911 NW 2ND Ave
Miami Gardens, FL 33169-2105
Phone
(786) 297-0070
NPI assigned
Mar 18, 2014
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 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 9203060 FL Primary

Addresses

Primary practice location

20911 NW 2ND Ave
Miami Gardens, FL 33169-2105

Mailing address

10920 Olive Ave
Pembroke Pines, FL 33026-1503
Phone (786) 297-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140930002379 FL Practitioner - Nurse Practitioner 6103046867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Jewish Health Systems IncGroup PAC ID 6507856614, 20 clinicians

Practice addresses (Care Compare)

5200 NE 2ND Ave
Miami, FL 33137-2706
Phone (305) 762-1387

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9203060FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Jewish Health Systems, Inc. CurrentSince Mar 15, 2022 Accepting new patients
American Care Inc. Past Accepting new patients

Locations

5200 NE 2nd Ave
Miami, FL 33137
Phone (305) 762-1387

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1568889335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 OLIVE AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261503",
            "telephone_number": "786-297-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20911 NW 2ND AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331692105",
            "telephone_number": "786-297-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAMDIE",
        "first_name": "EKOM",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9203060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.