NPIMap

Organization Active NPI

Eze Family Health Center, Inc.

  • Clinic/Center
  • Waldorf, MD
National Provider Identifier
1871874859
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
D69441 Issued in MD
Legal business name
EZE FAMILY HEALTH CENTER, INC.
Practice address
11750 Business Park Dr
Suite 103
Waldorf, MD 20601-2907
Phone
(301) 323-3921
Fax
(888) 519-5179
NPI assigned
Sep 2, 2011
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Chinyere Eze, PA-CNPI 1003032855
Title
Medical Practitioner / Ceo
Phone
(301) 323-3921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X D0037088 MD
Clinic/Center 261Q00000X D69441 MD Primary
Medical Physician Assistant 363AM0700X C0004111 MD

Addresses

Primary practice location

11750 Business Park Dr
Suite 103
Waldorf, MD 20601-2907

Mailing address

11750 Business Park Dr
Suite 103
Waldorf, MD 20601-2907
Phone (301) 323-3921

Other identifiers 1

IdentifierTypeStateIssuer
1003032855OtherMDNPPES (NPI)

Other names 1

  • Eze Health Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1871874859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 BUSINESS PARK DR",
            "address_2": "SUITE 103",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012907",
            "telephone_number": "301-323-3921",
            "fax_number": "888-519-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 BUSINESS PARK DR",
            "address_2": "SUITE 103",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012907",
            "telephone_number": "301-323-3921",
            "fax_number": "888-519-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZE FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "EZE",
        "authorized_official_first_name": "CHINYERE",
        "authorized_official_title_or_position": "MEDICAL PRACTITIONER / CEO",
        "authorized_official_telephone_number": "301-323-3921",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "D0037088",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "D69441",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES (NPI)",
            "identifier": "1003032855",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eze Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.