Edith Ifeyinwa Ezekwe, RDN, ASCP,

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

914536 Issued in MS

Practice address

703 Farmer St
Port Gibson, MS 39150-2319

Phone

(601) 437-5668

NPI assigned

Feb 3, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1578377404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BROOKWOOD DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391831622",
            "telephone_number": "601-415-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 FARMER ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502319",
            "telephone_number": "601-437-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEKWE",
        "first_name": "EDITH",
        "middle_name": "IFEYINWA",
        "name_prefix": "Dr.",
        "credential": "RDN, ASCP,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "MS",
            "license": "914536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obesity and Weight Management Nutrition Registered Dietitian in Port Gibson, MS
• Providers in Port Gibson, MS by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.