Individual provider Active NPI

Chiazor Eziakor, DNP, PMHNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1831541754
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN189319 Issued in GA
Practice address
265 Boulevard NE
Atlanta, GA 30312-1208
Phone
(770) 948-4512
NPI assigned
Jul 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2019082358 GA
Family Nurse Practitioner 363LF0000X F06162151 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN189319 GA Primary

Addresses

Primary practice location

265 Boulevard NE
Atlanta, GA 30312-1208

Mailing address

265 Boulevard NE
Atlanta, GA 30312-1208
Phone (770) 948-4512

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
I20161019002415 GA Practitioner - Nurse Practitioner 5395033005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Glenlake Pkwy
Atlanta, GA 30328-3448
Phone (404) 849-7485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06162151GAMDFamily Nurse Practitioner
2019082358GAMDPsychiatric/Mental Health Nurse Practitioner
RN189319GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Integrated Psychiatric Services LLC Family CurrentSince Apr 14, 2022 Accepting new patients
Lung Care Specialists PC Past Accepting new patients

Locations

1 Glenlake Pkwy
Ste 650700
Sandy Springs, GA 30328
Phone (404) 849-7485

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1831541754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BOULEVARD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121208",
            "telephone_number": "770-948-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 BOULEVARD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121208",
            "telephone_number": "770-948-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIAKOR",
        "first_name": "CHIAZOR",
        "credential": "DNP, PMHNP-BC, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-02",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "2019082358",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F06162151",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN189319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.