Iocck Healthcare Services, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

IOCCK HEALTHCARE SERVICES, LLC

Practice address

2875 Grandview Dr
Grand Prairie, TX 75052-8518

Phone

(214) 906-5427

NPI assigned

Sep 24, 2020

Organization subpart

No

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

Authorized official

Name

Ifeanyi Duruewuru, FNP

Title

Owner/Manager

Phone

(214) 906-5427

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1013524131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 GRANDVIEW DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528518",
            "telephone_number": "214-906-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 GRANDVIEW DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528518",
            "telephone_number": "214-906-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOCCK HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "DURUEWURU",
        "authorized_official_first_name": "IFEANYI",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "214-906-5427",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Immaculata Eme Inyang, FNP
• Oluwakemi Mausi Ipinlaye
• Irenee a. Lebuabanga (Amgc)
• Akhere Isenalumhe, PMHNP-BC
• Smitha Issac, FNP
• Kechauna Lashay Ivory

• Primary Care Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.