Active NPI
Stella O Ejiogu
- Primary Care Nurse Practitioner
- Tallahassee, FL
National Provider Identifier
1821778598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 11027346
- Practice address
- 2249 Lake Heritage Dr
Tallahassee, FL 32311-9486 - Phone
- (850) 345-7607
- NPI assigned
- Jul 19, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 11027346 | FL | Primary |
Addresses
Primary practice location
2249 Lake Heritage Dr
Tallahassee, FL 32311-9486
Mailing address
2249 Lake Heritage Dr
Tallahassee, FL 32311-9486
Phone (850) 345-7607
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11027346 | FL | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1821778598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2249 LAKE HERITAGE DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323119486",
"telephone_number": "850-345-7607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2249 LAKE HERITAGE DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323119486",
"telephone_number": "850-345-7607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EJIOGU",
"first_name": "STELLA",
"middle_name": "O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "FL",
"license": "11027346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.