Kimberli Omwanghe, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R8448 Issued in TX

Practice address

221 Regency Pkwy Ste 121
Mansfield, TX 76063

Phone

(817) 477-5884

Fax

(817) 453-8091

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emergency Staffing Solutions Region III

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1689967895

  AR

  Medicare reassignment NPD
• Frazier Enterprise Group LLC

  • Clinic/Center
  • Beaumont, TX
  • NPI 1811792161
  Medicare reassignment NPD

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1124413596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 REGENCY PKWY STE 121",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635379",
            "telephone_number": "817-477-5884",
            "fax_number": "817-453-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 REGENCY PKWY STE 121",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-477-5884",
            "fax_number": "817-453-8091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "661 E Main St Ste 900",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "TX",
            "postal_code": "760653343",
            "country_code": "US",
            "telephone_number": "469-612-5250",
            "fax_number": "469-612-5251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 E 6th St",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718545207",
            "country_code": "US",
            "telephone_number": "870-779-6000",
            "fax_number": "870-779-6093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMWANGHE",
        "first_name": "KIMBERLI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-10387",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adeniyi O Olusoga
• Kehinde Olusoga
• Gladys Omagbon
• Omega Psychiatry & Wellness
• Omni Senior Care Solutions
• Thomas Mwembi Onchoke
• Oncology Pharmacy Services, Inc.
• Leah Ondiek, LPC-S
• Evelyne Ongwae, AGACNP-BC
• Kimberly Nneka Onwubuya, PMHNP

• Family Medicine Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.