Nkechinyelu Nebeolisa, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10958 Issued in TX

Practice address

16185 Space Center Blvd
Houston, TX 77062-6210

Phone

(281) 486-1872

NPI assigned

Nov 17, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southlake Doctors Express, PA PSC

  • Urgent Care Clinic/Center
  • Southlake, TX
  • NPI 1942519335
  NPD
• Doctors Express of the Temple Area, PA

  • Urgent Care Clinic/Center
  • Temple, TX
  • NPI 1568696227
  NPD (past)
• Texas Home Physicians

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1154704815
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1013450345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11939 FIREBIRD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770994050",
            "telephone_number": "346-770-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16185 SPACE CENTER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770626210",
            "telephone_number": "281-486-1872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11939 Firebird Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770994050",
            "country_code": "US",
            "telephone_number": "281-455-1746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Gray Falls Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770776687",
            "country_code": "US",
            "telephone_number": "713-422-2920",
            "fax_number": "713-422-2920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEBEOLISA",
        "first_name": "NKECHINYELU",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA10958",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyesha Neal
• Tyree Pasini Neal
• Joseph Thomas Nealon, MD
• Chau Le Neason, MD
• Abongnwi Nebangwa
• Denise R Nebgen, M.D.
• Kavita Gope Nebhnani
• Charles Robert Neblett, MD
• Kimberly Nebo, PHARMD
• Nebula Imaging Center LLC

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.