Sandra Igbinehi Abusomwan
Individual provider Active NPI Family Nurse Practitioner · Frisco, TX
NPI 1023637303 · NPPES record last updated Apr 16, 2020
Key facts
- NPI
- 1023637303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP141724 (TX)
- Practice address
- 12436 Daisy LN
Frisco, TX 75035-0716 - Phone
- (469) 617-3070
- NPI assigned
- Apr 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12436 Daisy LN
Frisco, TX 75035-0716
Phone (972) 896-6144
Hospital & facility affiliations
- Gifted Healthcare Inc
- Glovis Home Health Services Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200609001302 | TX | Practitioner - Nurse Practitioner | 8729061825 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Odette Louise Campbell MD PA | Current |
Accepting new patients | |
| Sala Health House Call LLC | Current |
Accepting new patients |
Locations
11625 Custer Rd
Ste 110127
Frisco, TX 75035
11625 Custer Rd
#110127
Frisco, TX 75035
5072 W Plano Pkwy
Ste 220
Plano, TX 75093
Phone (469) 671-0900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP141724 | TX | Yes |
Addresses
Primary practice location
12436 Daisy LN
Frisco, TX 75035-0716
Mailing address
12436 Daisy LN
Frisco, TX 75035-0716
Other providers in Frisco, TX
- Teena Abraham
- Amie M Abshire
- John Abt
- Dora C Abuogi
- Dana Abusarah
- Access Counseling Group
- Access Counseling Group, Inc.
- Access Counseling Group, Inc.
- Access Counseling Group, Inc.
- Ace Physical Therapy and Wellness
All providers in Frisco, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.