Individual provider Active NPI

Demvihin Udokanma Ihyembe, M.D

  • Developmental - Behavioral Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1023304490
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
U3547 Issued in TX
Practice address
1300 W Lancaster Ave
Fort Worth, TX 76102-3410
Phone
(682) 303-9300
Fax
(682) 303-9245
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT198917 PA
Developmental - Behavioral Pediatrics Physician 2080P0006X A131522 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X 33192 OK
Developmental - Behavioral Pediatrics Physician 2080P0006X U3547 TX Primary

Addresses

Primary practice location

1300 W Lancaster Ave
Fort Worth, TX 76102-3410

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dihyembe202665@CookChildrens.direct-ci.com

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT198917PAMDPediatrics Physician
A131522CAMDDevelopmental - Behavioral Pediatrics Physician
U3547TXMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dihyembe202665@cookchildrens.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1023304490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023410",
            "telephone_number": "682-303-9300",
            "fax_number": "682-303-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHYEMBE",
        "first_name": "DEMVIHIN",
        "middle_name": "UDOKANMA",
        "name_prefix": "Miss",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT198917",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "A131522",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OK",
            "license": "33192",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "U3547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dihyembe202665@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1300 W Lancaster Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761023410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.