Active NPI
Nnonyitum S Ejesieme
- Home Health Agency
- Rowlett, TX
National Provider Identifier
1619170297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 011635
- Legal business name
- NNONYITUM S EJESIEME
- Practice address
- 2504 Larkspur LN
Rowlett, TX 75089-6733 - Phone
- (972) 365-7147
- Fax
- (972) 463-1671
- NPI assigned
- Jun 9, 2007
- Last updated
- Jun 1, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nnonyitum S Ejesieme, RN
- Title
- Owner Administrator
- Phone
- (972) 365-7147
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 011635 | TX | Primary |
Addresses
Primary practice location
2504 Larkspur LN
Rowlett, TX 75089-6733
Mailing address
2504 Larkspur LN
Rowlett, TX 75089-6733
Phone (972) 365-7147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080530000608 | TX | Part A Provider - Home Health Agency | 8022188267 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mesquite, TX |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1619170297. Details of each certification follow.
Home health agency certification: CCN 747182
- Legal name
- E-CARE HOME HEALTH SERVICES, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 11, 2009
- Last certification
- Nov 1, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 4, 2011 in TX
- Enrollment address
- 3939 US Highway 80 E
Ste 326B
Mesquite, TX 75150-3354
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Home health agency
Medicare Care Compare- Listed as
- E Care Home Health Services Inc
- Ownership
- Proprietary
- Certified
- Aug 11, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Bridget Ejesieme | Corporate Officer | Jun 1, 2013 | |
| W-2 Managing Employee | Jun 1, 2013 | ||
| Nnonyitum Ejesieme | 5% Or Greater Direct Ownership Interest | Jun 9, 2007 | 100% |
| W-2 Managing Employee | Jun 24, 2011 | ||
| Operational/Managerial Control | Jun 24, 2011 |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Psychiatric/Mental Health Nurse Practitioner
- Lewisville, TX
- NPI 1952560054
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212278400000",
"number": "1619170297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 LARKSPUR LN",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750896733",
"telephone_number": "972-365-7147",
"fax_number": "972-463-1671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2504 LARKSPUR LN",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750896733",
"telephone_number": "972-365-7147",
"fax_number": "972-463-1671"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NNONYITUM S EJESIEME",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-09",
"last_updated": "2008-06-01",
"status": "A",
"authorized_official_last_name": "EJESIEME",
"authorized_official_first_name": "NNONYITUM",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER ADMINISTRATOR",
"authorized_official_telephone_number": "972-365-7147",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "011635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.