Emmanuel E Eze, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

31810 Issued in KY

Practice address

1544 Winchester Ave
Suite 701
Ashland, KY 41101-7923

Phone

(606) 329-1016

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Three Rivers Medical Clinics Inc

  dba Three Rivers Family Practice - Riverview

  • Rural Health Clinic/Center
  • Louisa, KY
  • NPI 1437824406
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1770688079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050650",
            "telephone_number": "606-329-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 WINCHESTER AVE",
            "address_2": "SUITE 701",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017923",
            "telephone_number": "606-329-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZE",
        "first_name": "EMMANUEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "31810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115240",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64318108",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00133162",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "000000324519",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115962001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Everbloom ABA Therapy, LLC
• Sara Everman, PA-C
• Evolve Laboratories, LLC
• Express Care Pharmacy and More (Cornerstone Care)
• Express DME
• Fidelia Eze, CADC
• Hannah Fairchild, APRN
• Joseph Dwayne Fairchild, LPCC
• Fairview Elementary
• Fairview Independent Secondary Schools

• Psychiatry Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.