Individual provider Active NPI

Elochukwu Ezekakpu

  • Family Medicine Physician
  • Antioch, TN
National Provider Identifier
1568901734
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0-707-255-6 Issued in ZZ
Practice address
4004 Pineorchard PL
Antioch, TN 37013-1451
Phone
(615) 569-5920
NPI assigned
Feb 21, 2017
Last updated
Feb 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0-707-255-6ZZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.