Tina Chinwenwa Ezeh, - Medicare Clinical Nurse Specialist in Douglasville, GA

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Tina Chinwenwa Ezeh, is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health" in Douglasville, Georgia. Her current practice location is 5945 Azalea Ridge Dr, Douglasville, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 882-8673.

Tina Chinwenwa Ezeh is licensed to practice in Georgia (license number RN259954) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740996222.

Contact Information

Tina Chinwenwa Ezeh,
5945 Azalea Ridge Dr,
Douglasville, GA 30135-5590
(770) 882-8673
Not Available

Map and Direction




Provider's Profile

Full NameTina Chinwenwa Ezeh
GenderFemale
SpecialityClinical Nurse Specialist - Psychiatric/mental Health
Location5945 Azalea Ridge Dr, Douglasville, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1740996222
  • Provider Enumeration Date: 01/27/2023
  • Last Update Date: 08/26/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 1456711423
  • Enrollment ID: I20230721002907

Medical Identifiers

Medical identifiers for Tina Chinwenwa Ezeh such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1740996222NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SP0808XClinical Nurse Specialist - Psychiatric/mental Health RN259954 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tina Chinwenwa Ezeh allows following entities to bill medicare on her behalf.
Entity NameCapeside Psychiatry Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760891980
PECOS PAC ID: 5991926560
Enrollment ID: O20141023001370

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tina Chinwenwa Ezeh is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tina Chinwenwa Ezeh,
Po Box 6296,
Douglasville, GA 30154-0022

Ph: (770) 882-8673		Tina Chinwenwa Ezeh,
5945 Azalea Ridge Dr,
Douglasville, GA 30135-5590

Ph: (770) 882-8673

Reviews and Comments


Clinical Nurse Specialist Nurses in Douglasville, GA

Catherine Suzanne Allen, APRN, AGCNS-BC
Clinical Nurse Specialist
Medicare: Not Enrolled in Medicare
Practice Location: 5767 W Phillips Mill Rd, Douglasville, GA 30135
Phone: 404-452-8808    
Kathryn Ward Norton, DNP, AGACNP, ACNS
Clinical Nurse Specialist
Medicare: Accepting Medicare Assignments
Practice Location: 8954 Hospital Drive, Douglasville, GA 30134
Phone: 770-949-1500    Fax: 770-920-6434

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.