C Divine LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

C DIVINE LLC

Practice address

14406 Parkesgate Dr
Houston, TX 77083-5789

Phone

(832) 212-4739

NPI assigned

Sep 9, 2019

Last updated

Feb 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Emiliana EzechigboNPI 1114385762

Title

Chief Executive Officer

Phone

(832) 212-4739

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Emiliana Ezechigbo

  • Family Nurse Practitioner
  • Houston, TX
  • NPI 1114385762
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1952950289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14406 PARKESGATE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770835789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 PARKESGATE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770835789",
            "telephone_number": "832-212-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C DIVINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "EZECHIGBO",
        "authorized_official_first_name": "EMILIANA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "832-212-4739"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP128425",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.