Mabel Ezeonwu, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61351676 Issued in WA

Practice address

18115 Campus Way NE
Bothell, WA 98011-8246

Phone

(425) 352-3815

NPI assigned

Sep 6, 2022

Last updated

Sep 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

University of Cincinnati College of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1891416145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18115 CAMPUS WAY NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118246",
            "telephone_number": "425-352-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18115 CAMPUS WAY NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118246",
            "telephone_number": "425-352-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEONWU",
        "first_name": "MABEL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61351676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Everett
• Evergreen Care Solutions LLC
• Evergreen Nursing Solutions PLLC
• Evo Naturopathic Medicine and Wellness PLLC
• Extraordinary Wellness, PLLC
• Ezer Art Studio LLC
• Faith's Loving Care
• Falck USA, Inc.
• Einas Fathy Farag Abdelaziz
• Nora Riley Faram, MSW,MHP, LICSW

• Family Nurse Practitioner in Bothell, WA
• Providers in Bothell, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.