Individual provider Active NPI

Cynthia Obiageli Ejoh, APRN

  • Family Nurse Practitioner
  • Farmers Branch, TX
National Provider Identifier
1124844303
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1180345 Issued in TX
Practice address
1790 Mercer Pkwy Apt 8304
Farmers Branch, TX 75234-1454
Phone
(469) 763-6415
NPI assigned
Dec 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1180345 TX Primary

Addresses

Primary practice location

1790 Mercer Pkwy Apt 8304
Farmers Branch, TX 75234-1454

Mailing address

1790 Mercer Pkwy Apt 8304
Farmers Branch, TX 75234-1454
Phone (469) 763-6415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 14, 2025 through Jul 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1180345TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bomray Medical Clinic PastSince Sep 16, 1996 Accepting new patients
Sports and Spine Physical Therapy NC Inc Past Accepting new patients

Organizations & group practices 2

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": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1124844303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 MERCER PKWY APT 8304",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752341454",
            "telephone_number": "469-763-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 MERCER PKWY APT 8304",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752341454",
            "telephone_number": "469-763-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJOH",
        "first_name": "CYNTHIA",
        "middle_name": "OBIAGELI",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1180345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmers Branch, TX

Sources for this page

Verify at the official NPI Registry.