Oludare Temitope Ezekwudo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04190018 Issued in MI

Practice address

10722 Turning Leaf Dr
Baton Rouge, LA 70810-7628

Phone

(225) 761-5200

NPI assigned

Feb 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1770238495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 TURNING LEAF DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 TURNING LEAF DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107628",
            "telephone_number": "225-761-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEKWUDO",
        "first_name": "OLUDARE",
        "middle_name": "TEMITOPE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F04190018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HPPA",
            "affiliation": "N",
            "endpointDescription": "SECURED",
            "address_1": "10722 Turning Leaf Dr",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708107628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eyemart Express LLC
• Eyemart Express, LTD.
• Eyemax Family Optical
• Ez-Medical Supplies & Services Inc.
• Kate Ezebunwo
• Ifeoma L Ezenwabachili, MD
• Amal G Ezzaiyani, MD
• F C P a, LLC
• F C P a, LLC
• F C P a, LLC

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.