Lawretta Njideka Ezukanma, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1146978 Issued in TX

Practice address

9908 Lamberton Ter
Fort Worth, TX 76244-8514

Phone

(817) 980-5659

Fax

(817) 562-2544

NPI assigned

Oct 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Amanji LLC

  • Psychiatry Physician
  • Fort Worth, TX
  • NPI 1538937818
  Medicare reassignment Authorized official
• Lawdera Healthcare Service Inc

  • Home Health Agency
  • Fort Worth, TX
  • NPI 1063794543
  NPD (past) Authorized official

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1841526142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9908 LAMBERTON TER",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448514",
            "telephone_number": "817-980-5659",
            "fax_number": "817-562-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 LAMBERTON TER",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448514",
            "telephone_number": "817-980-5659",
            "fax_number": "817-562-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZUKANMA",
        "first_name": "LAWRETTA",
        "middle_name": "NJIDEKA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "719537",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1146978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin H Ezell, D.O.
• Dawn Denise Ezelle, COTA
• Uzoma I Ezeuka
• Ezra'S Homestead
• Ezukanma Group of Companies Inc
• F W Family Practice PA
• Jane Roxanne Fabela, M. ED. LMFTA
• Paul Andrew Fabela, M.D.
• Ashly Dawn Fabian
• Fabos Community Intersection, LLC

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.