Victoria O Obianwu

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1129635 Issued in TX

Practice address

1602 S Jackson St
Jacksonville, TX 75766-3028

Phone

(430) 205-4150

NPI assigned

Jul 24, 2023

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut East Texas Urgent Care Centers, PLLCGroup PAC ID 7517385388, 33 clinicians

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Mother Frances Hospital Regional Health Care CenterGroup PAC ID 9234025636, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vobianwu268208@christushealth.direct-ci.net
• Direct secure messaging: vobianwu915909@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Medicare reassignment Care Compare group NPD
• Ut East Texas Urgent Care Centers, PLLC

  • Urgent Care Clinic/Center
  • Canton, TX
  • NPI 1356974281
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jacksonville Hospital LLC

  dba UTHealth East Texas Jacksonville Hospital

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1124708078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757663028",
            "telephone_number": "430-205-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757663028",
            "telephone_number": "430-205-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018350",
            "country_code": "US",
            "telephone_number": "903-510-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031335",
            "country_code": "US",
            "telephone_number": "903-581-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBIANWU",
        "first_name": "VICTORIA",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1129635",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1129635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Paige Newman, COTA
• Nicole Groves, LPC PLLC
• Chad R Niles, MD
• Numed Imaging Centers, Inc
• Mabel N. Nwachukwu, PMHNP
• Ortholonestar, PLLC (Azalea Orthopedics & Sports Medicine Clinic)
• Megan Michelle Osorio, NP
• Oluwasegun Oyenpemi, PHARMD
• Zachary Taylor Page, MD
• Karli Paige Parra, MSN, APRN, CPNP-PC

• Nurse Practitioner in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.