Individual provider Active NPI

Ezechukwu Prince Ibekwe, RN

  • Psychiatric/Mental Health Registered Nurse
  • Richmond, VA
National Provider Identifier
1861937773
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
0001238827 Issued in VA
Practice address
2224 Watts LN
Richmond, VA 23223-1951
Phone
(804) 247-3997
NPI assigned
Dec 31, 2016
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001238827 VA
Community Health Registered Nurse 163WC1500X 0001238827 VA
Home Health Registered Nurse 163WH0200X 0001238827 VA
Psychiatric/Mental Health Registered Nurse 163WP0808X 0001238827 VA Primary

Addresses

Primary practice location

2224 Watts LN
Richmond, VA 23223-1951

Mailing address

2224 Watts LN
Richmond, VA 23223-1951
Phone (804) 247-3997

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001238827VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tricities Community Services, LLC Current Accepting new patients
Royal Pinnacle Services Current Accepting new patients
Pinnacle Healthcare LLC Current Accepting new patients

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": "1483142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1861937773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 WATTS LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232231951",
            "telephone_number": "804-247-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 WATTS LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232231951",
            "telephone_number": "804-247-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBEKWE",
        "first_name": "EZECHUKWU",
        "middle_name": "PRINCE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-31",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001238827",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "VA",
            "license": "0001238827",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "VA",
            "license": "0001238827",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0001238827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.