Individual provider Active NPI

Chinwendu Peace Onwusor

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1104649631
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024084929 Issued in TX
Practice address
411 N Washington Ave Ste 5200
Dallas, TX 75246-1778
Phone
(855) 204-2502
Fax
(817) 783-4672
NPI assigned
Nov 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 2024084929 TX Primary

Addresses

Primary practice location

411 N Washington Ave Ste 5200
Dallas, TX 75246-1778

Mailing address

1620 Pegasus Dr
Forney, TX 75126-1337
Phone (469) 269-9972

Other practice location 1

6020 W Parker Rd Ste 305
Plano, TX 75093-8350
Phone (855) 204-2502

Other practice location 2

2800 E Highway 114 Ste 350
Trophy Club, TX 76262-5309
Phone (855) 204-2502

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
I20251027002650 TX Practitioner - Nurse Practitioner 6709375280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kotel AtxGroup PAC ID 9537578810, 27 clinicians

Practice addresses (Care Compare)

Aubrey, TX 76227
Phone (469) 277-8991

Trophy Club, TX 76262
Phone (512) 777-2591

411 N Washington Ave
Suite 5200
Dallas, TX 75246-1778
Phone (855) 204-2502

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1184131TXMDPhysical Therapist
2024084929TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Care Home LLC CurrentSince Nov 10, 2024 Accepting new patients
Kotel Atx Single Specialty CurrentSince Aug 23, 2025 Accepting new patients
Confidant Texas PA Single Specialty Past Accepting new patients

Locations

411 N Washington Ave
Ste 5200
Dallas, TX 75246
Phone (773) 606-6594

6020 W Parker Rd
Ste 305
Plano, TX 75093
Phone (214) 380-0799

2800 E Highway 114
Ste 350
Trophy Club, TX 76262
Phone (817) 490-7856

3001 Bee Caves Rd
Ste 220
West Lake Hills, TX 78746

Organizations & group practices 3

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1104649631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 PEGASUS DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751261337",
            "telephone_number": "469-269-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461778",
            "telephone_number": "855-204-2502",
            "fax_number": "817-783-4672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6020 W Parker Rd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938350",
            "country_code": "US",
            "telephone_number": "855-204-2502",
            "fax_number": "817-783-4672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 E Highway 114 Ste 350",
            "address_purpose": "LOCATION",
            "city": "Trophy Club",
            "state": "TX",
            "postal_code": "762625309",
            "country_code": "US",
            "telephone_number": "855-204-2502",
            "fax_number": "817-783-4672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONWUSOR",
        "first_name": "CHINWENDU",
        "middle_name": "PEACE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2024084929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.