Individual provider Active NPI

Chidimma I Nguma, NP

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1114252798
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP127629 Issued in TX
Practice address
5323 Harry Hines Boulevard
Dallas, TX 75390-7201
Phone
(214) 645-4673
Fax
(972) 669-7194
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305110 NY
Gerontology Nurse Practitioner 363LG0600X F340722-1 NY
Adult Health Nurse Practitioner 363LA2200X AP127629 TX Primary

Addresses

Primary practice location

5323 Harry Hines Boulevard
Dallas, TX 75390-7201

Mailing address

P.O. Box 845347
Dallas, TX 75284-5347
Phone (214) 645-4673

Other names 1

  • Ms. Chidimma I Azoro Former name

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
I20250423000383 TX Order and Referring Only - Nurse Practitioner 2062544794

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F305110NYMDAdult Health Nurse Practitioner
AP127629TXMDAdult Health Nurse Practitioner
F340722-1NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Home Care Solutions, LLC Current Accepting new patients

Organizations & group practices 1

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1114252798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-4673",
            "fax_number": "972-669-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BOULEVARD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-645-4673",
            "fax_number": "972-669-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUMA",
        "first_name": "CHIDIMMA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305110",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340722-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP127629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIDIMMA",
            "last_name": "AZORO",
            "middle_name": "I",
            "prefix": "MS.",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.