Active NPI
Vivian Ikegbunam, PHARM D
- Pharmacist
- Mansfield, TX
National Provider Identifier
1144944851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69424
- Practice address
- 2882 Highway 157 N
Mansfield, TX 76063-8835 - Phone
- (817) 453-4080
- NPI assigned
- Sep 27, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69424 | TX | Primary |
Addresses
Primary practice location
2882 Highway 157 N
Mansfield, TX 76063-8835
Mailing address
8115 Mossberg Dr
Arlington, TX 76002-5705
Phone (214) 478-4227
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69424 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy 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": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1144944851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8115 MOSSBERG DR",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760025705",
"telephone_number": "214-478-4227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2882 HIGHWAY 157 N",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760638835",
"telephone_number": "817-453-4080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEGBUNAM",
"first_name": "VIVIAN",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-27",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "69424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.