John Ejikeme, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10033753 Issued in OR

Practice address

29398 Recovery Way
Junction City, OR 97448-8447

Phone

(541) 465-2554

NPI assigned

Apr 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR, TX3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 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 and National Provider Directory roles.

• Eastgate Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
  • NPI 1184509093

  Psychiatric/Mental Health, TX

  Medicare reassignment NPD Authorized official
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489

  OR

  Medicare reassignment NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  WA

  Medicare reassignment NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Vancouver, WA
  • NPI 1407002892
  NPD

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

{
    "created_epoch": "1556323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1962066738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 4TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774619",
            "telephone_number": "214-875-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29398 RECOVERY WAY",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974488447",
            "telephone_number": "541-465-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIKEME",
        "first_name": "JOHN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-27",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "939339",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP6139409",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10033753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Dupont
• Danny Lee Durbin, MS
• Karen Melody Dyer-McGowan
• Lauren Rae Earley, PA-C
• Scott Eastburn
• Georgia England
• Tiffany Enos
• Marcelina Gloria Entizne
• Tracie Eoff
• Rodney Estes

• All providers in Junction City, OR
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.