Individual provider Active NPI

Elisha Mudzana

  • Religious Nonmedical Practitioner
  • Plano, TX
National Provider Identifier
1053894600
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical PractitionerTaxonomy code 374K00000X
Practice address
7116 Libby Rd # 4253
Plano, TX 75024-4937
Phone
(214) 660-6830
NPI assigned
Sep 10, 2018
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Practitioner 374K00000X Primary

Addresses

Primary practice location

7116 Libby Rd # 4253
Plano, TX 75024-4937

Mailing address

6009 W Parker Rd Ste 149-402
Plano, TX 75093-8120
Phone (214) 660-6830

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

Practice roles

OrganizationSpecialtyStatusNew patients
Venture Non Emergency Transportation LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1053894600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 W PARKER RD STE 149-402",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938120",
            "telephone_number": "214-660-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7116 LIBBY RD # 4253",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244937",
            "telephone_number": "214-660-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDZANA",
        "first_name": "ELISHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.