Individual provider Active NPI

Kushum Pokharel, NP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1104328673
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136816 Issued in TX
Practice address
9036 Sunridge Circle Apt 236
Fort Worth, TX 76120
Phone
(256) 797-3968
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 AP136816 TX Primary

Addresses

Primary practice location

9036 Sunridge Circle Apt 236
Fort Worth, TX 76120

Mailing address

9036 Sunridge Circle Apt 236
Fort Worth, TX 76120
Phone (256) 797-3968

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
I20181204003624 TX Practitioner - Nurse Practitioner 2860736600 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP136816TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Laxmideepika Koya, M.D.,P.a CurrentSince Feb 1, 2020 Accepting new patients

Locations

118 Lynn Ave
Ste 500
Lewisville, TX 75057
Phone (214) 888-0670

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1104328673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9036 SUNRIDGE CIRCLE APT 236",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76120",
            "telephone_number": "256-797-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9036 SUNRIDGE CIRCLE APT 236",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76120",
            "telephone_number": "256-797-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKHAREL",
        "first_name": "KUSHUM",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.