Individual provider Active NPI

Ijeje Eteng Eno, APRN

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1073091260
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138145 Issued in TX
Practice address
5440 Harvest Hill Rd Ste 182
Dallas, TX 75230-1605
Phone
(972) 484-0040
Fax
(972) 484-0070
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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 AP138145 TX Primary

Addresses

Primary practice location

5440 Harvest Hill Rd Ste 182
Dallas, TX 75230-1605

Mailing address

5440 Harvest Hill Rd Ste 182B
Dallas, TX 75230-1607
Phone (214) 348-7611

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
I20180907000260 TX Practitioner - Nurse Practitioner 2163772450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.47 of 100Reported as group
Quality
82.96
Improvement activities
40
Cost
44.28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Physician'S Network, Inc CurrentSince Aug 1, 2018 Accepting new patients
Care Track Consulting LLC Past Accepting new patients

Locations

5440 Harvest Hill Rd
Ste 182
Dallas, TX 75230
Phone (972) 484-0040

5440 Harvest Hill Rd
Ste 182B
Dallas, TX 75230
Phone (214) 348-7611

Organizations & group practices 2

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1073091260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 HARVEST HILL RD STE 182B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301607",
            "telephone_number": "214-348-7611",
            "fax_number": "214-348-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 HARVEST HILL RD STE 182",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301605",
            "telephone_number": "972-484-0040",
            "fax_number": "972-484-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENO",
        "first_name": "IJEJE",
        "middle_name": "ETENG",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.