Mispa Ewube Nkongho, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1050549 Issued in TX

Practice address

2212 Bald Eagle Way
Grand Prairie, TX 75052-4138

Phone

(214) 900-2529

NPI assigned

Aug 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NM, CO3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spectrum Healthcare Group IncGroup PAC ID 3072411388, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mispa.nkongho.p1@direct.spectrumhg.nextgenshare.com

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.

• Spectrum Healthcare Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cottonwood, AZ
  • NPI 1487635389

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Bethel Hills Integrated Healthcare PLLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1578104154

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CO, Psychiatric/Mental Health

  Medicare reassignment NPD
• Spectrum Healthcare Group, Inc

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1053834218
  NPD
• Spectrum Healthcare Group, Inc

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1912614413

  Psychiatric/Mental Health

  NPD
• Spectrum Healthcare Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1831811850

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1628985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1083389662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 BALD EAGLE WAY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524138",
            "telephone_number": "214-900-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 BALD EAGLE WAY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524138",
            "telephone_number": "214-900-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKONGHO",
        "first_name": "MISPA",
        "middle_name": "EWUBE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-15",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1050549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• North Texas Medical Associates

• Psychiatric/Mental Health Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.