DR. ODILICHI EZENWANNE M.D.
NPI 1841504206
Preventive Medicine - Public Health & General Preventive Medicine in Tunica, MS

Active since July 27, 2010PECOS EnrolledAccepts Medicare Assignment
1820 PEABODY ST, TUNICA, MS 38676(662) 363-3656 Get Directions Write a Review

NPPES record last updated: February 18, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 18, 2020, Jun 27, 2017 (2 updates tracked since 2017).

About Dr. Odilichi Ezenwanne M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ODILICHI EZENWANNE M.D. (NPI 1841504206) is an individual public health & general preventive medicine provider in Tunica, Mississippi, licensed in Wisconsin (67275) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Baptist Memorial Hospital Desoto, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1841504206
Entity TypeIndividualMale
Primary Taxonomy2083P0901X
Provider Legal NameDR. ODILICHI EZENWANNECredential: M.D.
Location Address1820 PEABODY STTunica, MS 38676-9441
Mailing Address1820 Peabody StTunica, MS 38676-9441 · (662) 363-3656 · Fax (662) 363-3789
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 27, 2010
Last NPPES UpdateFebruary 18, 20202 updates tracked since enumeration
NPI 1841504206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPreventive Medicine · Public Health & General Preventive MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0901X
Licenses Licensed in WI · 67275 Licensed in MS · 27125
Definition

Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.

1820 PEABODY ST, Tunica, MS 38676

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Odilichi Ezenwanne M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406127265
PECOS Enrollment IDI20191220001793
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Memorial Hospital Desoto

Acute Care Hospitals · Southaven, MS
1/5 CMS rating
OwnershipProprietary
CMS Certification Number250141
Location7601 Southcrest ParkwaySouthaven, MS 38671 · De Soto County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38676 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Federally Qualified Health Center (FQHC))
1820 PEABODY ST
TUNICA, MS 38676
Nurse Practitioner (Family)
1820 PEABODY ST
TUNICA, MS 38676

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Odilichi Ezenwanne's NPI number?

The NPI number for Odilichi Ezenwanne is 1841504206. It was assigned to this individual provider in the NPPES registry on July 27, 2010.

Where is Odilichi Ezenwanne located?

Odilichi Ezenwanne practices at 1820 Peabody St, Tunica, MS 38676. The listed phone number is (662) 363-3656.

What is Odilichi Ezenwanne's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Public Health & General Preventive Medicine, with taxonomy code 2083P0901X.

Is Odilichi Ezenwanne enrolled in Medicare?

Yes. Odilichi Ezenwanne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Odilichi Ezenwanne accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Odilichi Ezenwanne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Odilichi Ezenwanne affiliated with any hospitals?

According to CMS data, Odilichi Ezenwanne is affiliated with Baptist Memorial Hospital Desoto.

When was this NPI record last updated?

The NPPES record for Odilichi Ezenwanne was last updated on February 18, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.