Individual provider Active NPI

Eberechi Kalu, DNP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1700290376
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN206385 Issued in GA
Practice address
2680 Lawrenceville Highway
Suite 202
Decatur, GA 30033-2526
Phone
(470) 250-1418
Fax
(678) 487-8644
NPI assigned
Jun 11, 2014
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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 RN206385 GA Primary

Addresses

Primary practice location

2680 Lawrenceville Highway
Suite 202
Decatur, GA 30033-2526

Mailing address

2680 Lawrenceville Highway
Suite 202
Decatur, GA 30033-2526
Phone (470) 250-1418

Other names 1

  • Eberechi Kalu-Uchenna Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818003687 GA Practitioner - Nurse Practitioner 0749458065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Linduc PC CurrentSince Feb 11, 2015 Accepting new patients
Linduc PC CurrentSince Apr 17, 2011 Accepting new patients

Locations

2680 Lawrenceville Hwy
Ste 202
Decatur, GA 30033
Phone (470) 250-1418

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1700290376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HIGHWAY",
            "address_2": "SUITE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "678-487-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HIGHWAY",
            "address_2": "SUITE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "678-487-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALU",
        "first_name": "EBERECHI",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBERECHI",
            "last_name": "KALU-UCHENNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.