Gloria Oluchi Ikonne

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP146154 Issued in TX

Practice address

1001 East Hebron Pkwy Suite 118-297
Carrollton, TX 75010-1015

Phone

(469) 381-9070

NPI assigned

Jul 23, 2020

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 TX, NY, OR, AZ4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  OR

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1114536364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 RIDGE LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750101210",
            "telephone_number": "469-381-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 EAST HEBRON PKWY SUITE 118-297",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750101015",
            "telephone_number": "469-381-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKONNE",
        "first_name": "GLORIA",
        "middle_name": "OLUCHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP146154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Medical Supplies
• Ies Carrollton PLLC
• Deborah C Igidi, MANAGER
• IHS Acquisition No 132 Inc
• Asifa Ijaz, M.D
• Immanuel Family Clinic PLLC
• Impel Management Services, LLC
• Imperial Diagnostics LLC
• Implants & Gumcare PA
• Imvaria Labs LLC

• Family Nurse Practitioner in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.