Individual provider Active NPI

Jessica Ifeoma Ezika, NP

  • Family Nurse Practitioner
  • Alpharetta, GA
National Provider Identifier
1669903159
Registry record updated Mar 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN189053 Issued in GA
Practice address
700 Venue Way
Apt. 7108
Alpharetta, GA 30005-4525
Phone
(215) 896-4115
NPI assigned
Mar 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN189053 GA Primary

Addresses

Primary practice location

700 Venue Way
Apt. 7108
Alpharetta, GA 30005-4525

Mailing address

700 Venue Way
Apt. 7108
Alpharetta, GA 30005-4525
Phone (215) 896-4115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN189053GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490400000000",
    "number": "1669903159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 VENUE WAY",
            "address_2": "APT. 7108",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054525",
            "telephone_number": "215-896-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 VENUE WAY",
            "address_2": "APT. 7108",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054525",
            "telephone_number": "215-896-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIKA",
        "first_name": "JESSICA",
        "middle_name": "IFEOMA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2017-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN189053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2017; 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.