Individual provider Active NPI

Hannah Ogechi Ephraim, MD

  • General Practice Physician
  • Lake City, FL
National Provider Identifier
1841174745
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1728 Issued in FL
Practice address
155 NW Enterprise Way
Lake City, FL 32055-8837
Phone
(850) 487-6357
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1728 FL Primary

Addresses

Primary practice location

155 NW Enterprise Way
Lake City, FL 32055-8837

Mailing address

155 NW Enterprise Way
Lake City, FL 32055-8837
Phone (850) 487-6357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250809000211 FL Practitioner - General Practice 6709384746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Doctors Intrastate LLCGroup PAC ID 5395161186, 74 clinicians

Practice addresses (Care Compare)

155 NW Enterprise Way
Island Doctors of Lake City
Lake City, FL 32055-8839
Phone (386) 487-6357

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Island Doctors Intrastate LLC CurrentSince Aug 4, 2025 Accepting new patients
Roy H Hinman MD PA CurrentSince Aug 4, 2025 Accepting new patients
Lina L Feaster PA PastSince Jan 2, 2004 Accepting new patients

Locations

811 N Summit St
Crescent City, FL 32112
Phone (386) 698-2101

1037 W US Highway 90
Ste 130
Lake City, FL 32055
Phone (386) 487-6357

155 NW Enterprise Way
Lake City, FL 32055
Phone (352) 371-7546

100 Arricola Ave
St Augustine, FL 32080
Phone (904) 825-4368

103 Anastasia Blvd
St Augustine, FL 32080
Phone (904) 825-4747

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1841174745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NW ENTERPRISE WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558837",
            "telephone_number": "850-487-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NW ENTERPRISE WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558837",
            "telephone_number": "850-487-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPHRAIM",
        "first_name": "HANNAH",
        "middle_name": "OGECHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.