DR. EZINNE KANU (MD) – Psychiatry Physician, NPI 1205452935

DR. EZINNE KANU (MD) is a healthcare provider. based in Augusta, Georgia. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 2023044187 (MO). The NPI Number for DR. EZINNE KANU (MD) is 1205452935

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. EZINNE KANU (MD)
NPI
1205452935
Phone
(214) 864-1746
Address
1480 WRIGHTSBORO RD APT 1326
Enumeration Date
18 June 2020
Last Update Date
4 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4178310150
Graduation Year
2019 (7 years ago)
PAC ID
8820412737
Group Practice PAC ID
5395653562
Professional Enrollment ID
I20240729001968
Address ID
MO658061131SP440XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:5State licenses:2Digital endpointsOther names

832 PSYCHIATRY in GA

Provider Addresses for DR. EZINNE KANU (MD)

  • 1480 WRIGHTSBORO RD APT 1326

    AUGUSTA, GA 309013209

    Phone: (214) 864-1746

    Type: Mailing

  • 997 SAINT SEBASTIAN WAY

    AUGUSTA, GA 309122613

    Phone: (706) 721-6715

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240729001968IPsychiatryMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395653562View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Physician AssistantMO
Family PracticeMO
Physician AssistantMO
Nurse PractitionerMO
Nurse PractitionerMO
O B S T E T R I C S/ G Y N E C O L O G YMO
Family PracticeMO

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. EZINNE KANU (MD)?
DR. EZINNE KANU (MD) — NPI 1205452935 — is the standard way to identify this listing.
Is DR. EZINNE KANU (MD) listed as active for patients and plans?
The listing shows DR. EZINNE KANU (MD) as active in the NPI system.
What taxonomy line describes DR. EZINNE KANU (MD)?
For research purposes, treat DR. EZINNE KANU (MD) as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. EZINNE KANU (MD) list a practice location?
Patients near Augusta, Georgia may find DR. EZINNE KANU (MD) in results; validate coverage separately.
Is the information about DR. EZINNE KANU (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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