Individual provider Active NPI

Chioma Imelda Eze, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1912518432
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1008439 Issued in TX
Practice address
5151 Harry Hines Blvd
Dallas, TX 75235-7707
Phone
(908) 821-6770
NPI assigned
Aug 10, 2020
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1008439 TX Primary

Addresses

Primary practice location

5151 Harry Hines Blvd
Dallas, TX 75235-7707

Mailing address

5151 Harry Hines Blvd
Dallas, TX 75235-7707
Phone (817) 744-8125

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dallas Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1008439TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Era Mental Health PLLC Psychiatric/Mental Health CurrentSince Dec 17, 2022 Accepting new patients
Unique Mental Health Services PLLC Psychiatric/Mental Health CurrentSince Jan 17, 2023 Accepting new patients

Locations

4610 200th St SW
Ste J
Lynnwood, WA 98036
Phone (253) 600-9339

Organizations & group practices 2

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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1912518432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357707",
            "telephone_number": "817-744-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357707",
            "telephone_number": "908-821-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZE",
        "first_name": "CHIOMA",
        "middle_name": "IMELDA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1008439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dallas",
            "affiliation": "N",
            "endpointDescription": "HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "n/a",
            "address_1": "5151 Harry Hines Blvd",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752357707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.