| Endo 247 Llc | |
|
5220 Park Ave Ste 202 Memphis TN 38119-3549 | |
| (901) 744-3362 | |
| Not Available |
| Full Name | Endo 247 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5220 Park Ave Ste 202, Memphis, Tennessee |
| Authorized Official Name and Position | Cherechi C. Ogwo (CHIEF MANAGER/PROVIDER) |
| Authorized Official Contact | 9017443362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endo 247 Llc 875 W Poplar Ave Ste 23 #102 Collierville TN 38017-2598 Ph: (901) 744-3362 | Endo 247 Llc 5220 Park Ave Ste 202 Memphis TN 38119-3549 Ph: (901) 744-3362 |
| NPI Number | 1255953956 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 7517388556 |
|---|---|
| Medicare Enrollment ID | O20200531000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255953956 | NPI | - | NPPES |
| Q057155 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Nykkia Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134316250 PECOS PAC ID: 6204019649 Enrollment ID: I20151110000662 |
| Provider Name | Cherechi C Ogwo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1720321060 PECOS PAC ID: 8729226600 Enrollment ID: I20190829004381 |
| Provider Name | Andrea W Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033727235 PECOS PAC ID: 2365855046 Enrollment ID: I20210120000602 |
| Provider Name | Tiara Nicole Richmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033829775 PECOS PAC ID: 2163897109 Enrollment ID: I20230405001802 |
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