Individual provider Active NPI

Augustina Ihuoma Iheanacho

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1114435401
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP135617 Issued in TX
Practice address
9401 Southwest Fwy
Houston, TX 77074-1407
Phone
(713) 970-7000
NPI assigned
Jan 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135617 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP135617 TX Primary

Addresses

Primary practice location

9401 Southwest Fwy
Houston, TX 77074-1407

Mailing address

11735 Berry Meadow Dr
Houston, TX 77071-3266
Phone (832) 863-8803

Other practice location 1

8700 Commerce Park Dr Ste 130
Houston, TX 77036-7430
Phone (281) 888-3671

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
I20220329002703 TX Practitioner - Nurse Practitioner 2668564295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Harris Center for Mental Health and IddGroup PAC ID 9739088790, 122 clinicians

Practice addresses (Care Compare)

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 970-7000

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-7000

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
78.41
Improvement activities
40
Cost
77.88

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Harris Center for Mental Health and Idd CurrentSince Jan 3, 2022 Accepting new patients
Dynasty Healthcare Services, Inc. Past Accepting new patients
Evangeline Memorial Clinic, Inc PastSince Sep 28, 2009 Accepting new patients

Locations

9401 Southwest Fwy
Houston, TX 77074
Phone (713) 970-3344

1502 Taub Loop
Houston, TX 77030
Phone (713) 873-4900

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chase Healthcare Services IncStafford, TX, CCN 747180 Home health agency W-2 Managing Employee Nov 21, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1516406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1114435401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11735 BERRY MEADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770713266",
            "telephone_number": "832-863-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Commerce Park Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770367430",
            "country_code": "US",
            "telephone_number": "281-888-3671",
            "fax_number": "281-888-3546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHEANACHO",
        "first_name": "AUGUSTINA",
        "middle_name": "IHUOMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-20",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135617",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP135617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.