Individual provider Active NPI

Nkeiru P Anyanwu, NP

  • Gerontology Nurse Practitioner
  • Irving, TX
National Provider Identifier
1154701746
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN141396 Issued in TX
Practice address
6363 N State Highway 161 Ste 100
Irving, TX 75038-2239
Phone
(469) 200-3272
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 833979 TX
Gerontology Nurse Practitioner 363LG0600X APRN141396 TX Primary

Addresses

Primary practice location

6363 N State Highway 161 Ste 100
Irving, TX 75038-2239

Mailing address

6706 Lake Jackson Dr
Arlington, TX 76002-4048
Phone (817) 501-3654

Other practice location 1

6706 Lake Jackson Dr
Arlington, TX 76002-4048
Phone (817) 501-3654

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200224000079 TX Practitioner - Nurse Practitioner 7113354622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olusegun Oseni PAGroup PAC ID 7012049406, 4 clinicians

Practice addresses (Care Compare)

1200 Clear Lake Rd
Weatherford, TX 76086-5802
Phone (817) 594-9993

Hospital & facility affiliations

  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
833979TXMDGeneral Practice Registered Nurse
APRN141396TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olusegun Oseni PA CurrentSince Feb 3, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 5, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 5, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

1200 Clear Lake Rd
Weatherford, TX 76086
Phone (817) 594-9993

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEJACA/Endpoint/CEJACA

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1154701746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 LAKE JACKSON DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760024048",
            "telephone_number": "817-501-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 N STATE HIGHWAY 161 STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382239",
            "telephone_number": "469-200-3272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6706 Lake Jackson Dr",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760024048",
            "country_code": "US",
            "telephone_number": "817-501-3654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "NKEIRU",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "833979",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "APRN141396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.