NPIMap

Individual provider Active NPI

Ejike Ofoemezie, MD

  • Psychiatry Physician
  • Concord, NC
National Provider Identifier
1871931857
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2017-01909 Issued in NC
Practice address
380 Copperfield Blvd NE
Concord, NC 28025-2402
Phone
(704) 403-1800
NPI assigned
Jun 12, 2013
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2017-01909 NC Primary

Addresses

Primary practice location

380 Copperfield Blvd NE
Concord, NC 28025-2402

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

923 N 2nd St
Ste 105
Albemarle, NC 28001-3317
Phone (704) 403-1877

Other practice location 2

5427 Hwy 49 S
Ste 105
Harrisburg, NC 28075
Phone (704) 454-7268

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center-Northeast Psychiatry Past Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Psychiatry PastSince Aug 1, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Psychiatry PastSince Aug 1, 2019 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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1871931857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252402",
            "telephone_number": "704-403-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 N 2nd St",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013317",
            "country_code": "US",
            "telephone_number": "704-403-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5427 Hwy 49 S",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "28075",
            "country_code": "US",
            "telephone_number": "704-454-7268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFOEMEZIE",
        "first_name": "EJIKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2020-09-28",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2017-01909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.