Ekele Adaeze Ezirim

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1112765 Issued in TX

Practice address

4534 Maplewood Ave
Balch Springs, TX 75180-4355

Phone

(719) 314-8789

NPI assigned

Oct 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

University of Texas Medical Branch at Galveston, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Visiting Clinicians PLLCGroup PAC ID 2668785791, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Primary Visiting Clinicians PLLC

  dba PVC Family Practice

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1720468390
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1780456657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534 MAPLEWOOD AVE",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751804355",
            "telephone_number": "719-314-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4534 MAPLEWOOD AVE",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751804355",
            "telephone_number": "719-314-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIRIM",
        "first_name": "EKELE",
        "middle_name": "ADAEZE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1112765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Egbuka
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• Fresenius Medical Care Balch Springs, LLC (Fresenius Kidney Care Balch Springs Home)
• Fresenius Medical Care Balch Springs, LLC (Fresenius Kidney Care Balch Springs)
• Matthew Richmond Geurin, PHARMD

• Primary Care Nurse Practitioner in Balch Springs, TX
• Providers in Balch Springs, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.