Individual provider Active NPI

Jane Udeh

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1073071429
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140286 Issued in TX
Practice address
909 N Washington Ave
Dallas, TX 75246-1520
Phone
(214) 820-9302
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP140286 TX Primary

Addresses

Primary practice location

909 N Washington Ave
Dallas, TX 75246-1520

Mailing address

1837 Lewis Dr
Garland, TX 75041-4142

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
I20220328002123 TX Practitioner - Nurse Practitioner 1850786922 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP140286TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Single Specialty CurrentSince Mar 1, 2022 Accepting new patients
Vpa of Texas PLLC CurrentSince Mar 1, 2022 Accepting new patients
Vpa of Texas PLLC Single Specialty Current Accepting new patients
Vpa of Texas PLLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 4

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": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1073071429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 LEWIS DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750414142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N WASHINGTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461520",
            "telephone_number": "214-820-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDEH",
        "first_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.