NPIMap

Individual provider Active NPI

Sylvester Unchenna Ejeh, M.D

  • Cardiovascular Disease Physician
  • Fayetteville, NC
National Provider Identifier
1639186240
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2006-01668 Issued in NC
Practice address
3505 Village Dr
Fayetteville, NC 28304-4553
Phone
(910) 323-0065
Fax
(910) 323-0071
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 056823 GA
Specialist 174400000X MD0000038125 TN
Specialist 174400000X 00024686 AL
Cardiovascular Disease Physician 207RC0000X 2006-01668 NC Primary

Addresses

Primary practice location

3505 Village Dr
Fayetteville, NC 28304-4553

Mailing address

3505 Village Dr
Fayetteville, NC 28304-4553
Phone (910) 323-0065

Other identifiers 1

IdentifierTypeStateIssuer
817572582AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000430 NC Practitioner - Cardiovascular Disease (Cardiology) 2769379684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Cardiology PAGroup PAC ID 5890878581, 2 clinicians

Practice addresses (Care Compare)

3505 Village Dr
Fayetteville, NC 28304-4513

3505 Village Dr
Fayetteville, NC 28304-4553
Phone (910) 323-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00024686ALMDSpecialist
MD0000038125TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Cardiology, P.a. CurrentSince Jan 1, 2008 Accepting new patients
W. Ross Davis MD, PC Cardiovascular Disease Past Accepting new patients
Mid - South Heart Center PC Specialist Past Accepting new patients
Lagrange Troup County Hospital Authority Past Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients

Locations

3505 Village Dr
Fayetteville, NC 28304
Phone (910) 323-0065

3505 Village Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 323-0065

Interoperability endpoints

  • Direct secure messaging: sejeh27557@capefearvalley.direct-ci.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1639186240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044553",
            "telephone_number": "910-323-0065",
            "fax_number": "910-323-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044553",
            "telephone_number": "910-323-0065",
            "fax_number": "910-323-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJEH",
        "first_name": "SYLVESTER",
        "middle_name": "UNCHENNA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "056823",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000038125",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00024686",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2006-01668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "817572582A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.