Individual provider Active NPI

Chioma Ihebereme

  • Family Nurse Practitioner
  • Smyrna, DE
National Provider Identifier
1962239095
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012869 Issued in DE
Practice address
51 Deak Dr
Smyrna, DE 19977-1268
Phone
(302) 653-1281
Fax
(302) 653-1268
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LG-0012869 DE
Family Nurse Practitioner 363LF0000X LG-0012869 DE Primary

Addresses

Primary practice location

51 Deak Dr
Smyrna, DE 19977-1268

Mailing address

323 Lake Seymour Dr
Middletown, DE 19709-4657
Phone (240) 486-6087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20241016003431 DE Practitioner - Nurse Practitioner 9537691415 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0012869DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Medical Care PA CurrentSince Mar 3, 2025 Accepting new patients

Locations

51 Deak Dr
Smyrna, DE 19977
Phone (302) 653-1281

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1962239095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 LAKE SEYMOUR DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197094657",
            "telephone_number": "240-486-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 DEAK DR",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771268",
            "telephone_number": "302-653-1281",
            "fax_number": "302-653-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEBEREME",
        "first_name": "CHIOMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0012869",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

Verify at the official NPI Registry.