Fidelis Osondu Ebereonwu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RNP250307 Issued in AZ

Practice address

924 W Jessica LN
Phoenix, AZ 85041-3978

Phone

(480) 332-8764

NPI assigned

Nov 21, 2020

Sex

Male

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

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.

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 and National Provider Directory roles.

• Einfectionmd PC

  • Infectious Disease Physician
  • Phoenix, AZ
  • NPI 1417437526
  NPD
• Keep Going Counseling

  • Psychiatric/Mental Health Nurse Practitioner
  • Chandler, AZ
  • NPI 1790351658
  NPD

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1962005850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850413978",
            "telephone_number": "480-332-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850413978",
            "telephone_number": "480-332-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEREONWU",
        "first_name": "FIDELIS",
        "middle_name": "OSONDU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-21",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RNP250307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Gabrielle Ebbing, MD, MPH
• Lawrence Ebel, DMD
• Ebenezer Behavioral Care, LLC
• Ebenezer House I , LLC
• Ebenezer House, LLC
• Renee S Eberhardt, LMT
• Marian C Eberly, RN, LCSW
• Lance Eberson, MD
• Jennifer Ebner, D.D.S.
• John A. Ebner, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.