NPIMap

Organization Active NPI

Trophy Club Pediatrics PA

  • Primary Care Clinic/Center
  • Trophy Club, TX
National Provider Identifier
1083034839
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TROPHY CLUB PEDIATRICS PA
Practice address
2811 Mona Vale Rd
Trophy Club, TX 76262-3479
Phone
(708) 574-4199
NPI assigned
Apr 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Authorized official

Name
Dr. Charles O Onyeama, MDNPI 1821244781
Title
Pediatrician
Phone
(708) 574-4199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2811 Mona Vale Rd
Trophy Club, TX 76262-3479

Mailing address

625 Parkview Drive
Suite 102
Trophy Club, TX 76262-3479
Phone (817) 400-1572

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10021/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1083034839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 PARKVIEW DRIVE",
            "address_2": "SUITE 102",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762623479",
            "telephone_number": "817-400-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 MONA VALE RD",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762623479",
            "telephone_number": "708-574-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROPHY CLUB PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "ONYEAMA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "708-574-4199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.