Active NPI
Emelda Olisaeke
- Psychiatric/Mental Health Nurse Practitioner
- Desoto, TX
National Provider Identifier
1003527193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1100162
- Practice address
- 941 York Dr
Desoto, TX 75115-2065 - Phone
- (972) 283-6286
- NPI assigned
- Dec 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1100162 | TX | Primary |
Addresses
Primary practice location
941 York Dr
Desoto, TX 75115-2065
Mailing address
3100 Kirby Lane
Crandall, TX 75126
Phone (972) 513-6044
Other practice location 1
2000 Old Hickory Trl
DeSoto, TX 75115-2242
Phone (972) 513-6044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1100162 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1003527193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 KIRBY LANE",
"city": "CRANDALL",
"state": "TX",
"postal_code": "75126",
"telephone_number": "972-513-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "941 YORK DR",
"city": "DESOTO",
"state": "TX",
"postal_code": "751152065",
"telephone_number": "972-283-6286"
}
],
"practiceLocations": [
{
"address_1": "2000 Old Hickory Trl",
"address_purpose": "LOCATION",
"city": "DeSoto",
"state": "TX",
"postal_code": "751152242",
"country_code": "US",
"telephone_number": "972-513-6044",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLISAEKE",
"first_name": "EMELDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-08",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1100162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desoto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.