Active NPI
Chibugo Okonkwo, PA
- Physician Assistant
- Mesquite, TX
National Provider Identifier
1144790593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12476
- Practice address
- 2636 Cantura Dr
Mesquite, TX 75181-4661 - Phone
- (469) 733-8280
- NPI assigned
- Nov 28, 2018
- Last updated
- Nov 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12476 | TX | Primary |
Addresses
Primary practice location
2636 Cantura Dr
Mesquite, TX 75181-4661
Mailing address
2636 Cantura Dr
Mesquite, TX 75181-4661
Phone (469) 733-8280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12476 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543363200000",
"number": "1144790593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2636 CANTURA DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751814661",
"telephone_number": "469-733-8280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2636 CANTURA DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751814661",
"telephone_number": "469-733-8280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKONKWO",
"first_name": "CHIBUGO",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2018-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA12476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.