Active NPI
Elochukwu Ezekakpu
- Family Medicine Physician
- Antioch, TN
National Provider Identifier
1568901734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0-707-255-6
- Practice address
- 4004 Pineorchard PL
Antioch, TN 37013-1451 - Phone
- (615) 569-5920
- NPI assigned
- Feb 21, 2017
- Last updated
- Feb 21, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0-707-255-6 | ZZ | Primary |
Addresses
Primary practice location
4004 Pineorchard PL
Antioch, TN 37013-1451
Mailing address
4004 Pineorchard PL
Antioch, TN 37013-1451
Phone (615) 569-5920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-707-255-6 | ZZ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care Tonic Home Health Solutions, LLC | Current | Accepting new patients | |
| Caretonic Home Health Solutions | Current | Accepting new patients | |
| Greenways Care, LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- In Home Supportive Care Agency
- Murfreesboro, TN
- NPI 1528656287
-
- In Home Supportive Care Agency
- Scottsdale, AZ
- NPI 1831868629
-
- Home Health Agency
- Nashville, TN
- NPI 1427927888
-
- In Home Supportive Care Agency
- Antioch, TN
- NPI 1184175671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1568901734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4004 PINEORCHARD PL",
"city": "ANTIOCH",
"state": "TN",
"postal_code": "370131451",
"telephone_number": "615-569-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4004 PINEORCHARD PL",
"city": "ANTIOCH",
"state": "TN",
"postal_code": "370131451",
"telephone_number": "615-569-5920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEKAKPU",
"first_name": "ELOCHUKWU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-21",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ZZ",
"license": "0-707-255-6",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Antioch, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.