Active NPI
Adaobi Ezeokoli, MD
- Psychiatry Physician
- Savannah, GA
National Provider Identifier
1679153027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 12760
- Practice address
- 601 E 66TH St
Savannah, GA 31405-4519 - Phone
- (912) 662-0088
- NPI assigned
- Apr 10, 2021
- Last updated
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 12760 | GA | Primary |
Addresses
Primary practice location
601 E 66TH St
Savannah, GA 31405-4519
Mailing address
601 E 66TH St
Savannah, GA 31405-4519
Phone (912) 662-0088
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12760 | Other | GA | GEORGIA TRAINING PERMIT |
| 1679153027 | Other | GA | GEORGIA TRAINING PERMIT |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1679153027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E 66TH ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314054519",
"telephone_number": "912-662-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E 66TH ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314054519",
"telephone_number": "912-662-0088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEOKOLI",
"first_name": "ADAOBI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-10",
"last_updated": "2021-07-07",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "12760",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA TRAINING PERMIT",
"identifier": "12760",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA TRAINING PERMIT",
"identifier": "1679153027",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
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- Dawn Marie Fabian, MA
- Adrienne V. R. Fabrizio, MD
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.