Individual provider Active NPI

Florence Ifeyinwa Chinwuba, FNP- BC

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1063044048
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144948 Issued in TX
Practice address
1452 Junction Run
Mesquite, TX 75181-4409
Phone
(214) 675-9616
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP144948 TX Primary

Addresses

Primary practice location

1452 Junction Run
Mesquite, TX 75181-4409

Mailing address

1452 Junction Run
Mesquite, TX 75181-4409
Phone (214) 675-9616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114001728 TX Practitioner - Nurse Practitioner 7719904960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP144948TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Texas PLLC Family CurrentSince Oct 13, 2020 Accepting new patients
Eclipse Home Health Services, Inc. CurrentSince Aug 8, 2005 Accepting new patients
Minuteclinic Diagnostic of Texas PLLC CurrentSince Oct 13, 2020 Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5526 S Congress Ave
Austin, TX 78745
Phone (512) 462-3820

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

9101 Highway 6 N
Houston, TX 77095
Phone (281) 859-3209

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eclipse Home Health Services, Inc.Mesquite, TX, CCN 677819 Home health agency 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Indirect Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Aug 8, 2005
Aug 8, 2005
Aug 5, 2005
Aug 5, 2005
Aug 8, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1063044048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 JUNCTION RUN",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814409",
            "telephone_number": "214-675-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 JUNCTION RUN",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814409",
            "telephone_number": "214-675-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINWUBA",
        "first_name": "FLORENCE",
        "middle_name": "IFEYINWA",
        "credential": "FNP- BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.