Individual provider Active NPI

Christian C. Ewelike, RN

  • Adult Companion
  • Dallas, TX
National Provider Identifier
1063742682
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
License
614002 Issued in TX
Practice address
9550 Forest Lane
Ste 310
Dallas, TX 75243
Phone
(214) 710-7968
Fax
(214) 553-1747
NPI assigned
Jan 4, 2010
Last updated
Jan 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X 614002 TX Primary
Registered Nurse 163W00000X 614002 TX

Addresses

Primary practice location

9550 Forest Lane
Ste 310
Dallas, TX 75243

Mailing address

9550 Forest Lane
Ste 310
Dallas, TX 75243
Phone (214) 710-7968

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
614002TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1063742682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 FOREST LANE",
            "address_2": "STE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "214-710-7968",
            "fax_number": "214-553-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 FOREST LANE",
            "address_2": "STE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "214-710-7968",
            "fax_number": "214-553-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWELIKE",
        "first_name": "CHRISTIAN",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "TX",
            "license": "614002",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "614002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.