DR. ODILICHI EZENWANNE M.D.
NPI 1841504206
Preventive Medicine - Public Health & General Preventive Medicine in Tunica, MS
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 and is a graduate of Other (2001).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Odilichi Ezenwanne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Clarksdale, MS 38614
- Reassigned Medicare billing, Mississippi enrollment
- 23 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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.
Which organization bills Medicare for Odilichi Ezenwanne's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Odilichi Ezenwanne reassigns Medicare benefits to Aaron E. Henry Community Health (Clarksdale, MS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Odilichi Ezenwanne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Odilichi Ezenwanne accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 4 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.
When was this NPI record last updated?
The NPPES record for Odilichi Ezenwanne was last updated on February 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Odilichi Ezenwanne, M.D. · NPI 1841504206
Public Health & General Preventive Medicine physician in Tunica, Mississippi. Individual provider, active in the CMS NPPES registry since July 27, 2010.
## Identity
- **NPI:** 1841504206 (Entity type: Individual)
- **Enumerated:** July 27, 2010
- **Primary specialty:** Preventive Medicine - Public Health & General Preventive Medicine · taxonomy 2083P0901X
- **State license:** 67275 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 1820 PEABODY ST, Tunica, MS 38676-9441
- **Phone:** (662) 363-3656
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Aaron E. Henry Community Health (NPI 1104574847, Clarksdale, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2001
## Record status
- **NPPES last updated:** February 18, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1841504206) · Data from the CMS NPPES public registry.