Individual provider Active NPI

David Osagie Okumbor, M.D

  • Family Medicine Physician
  • Terrell, TX
National Provider Identifier
1164616199
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N1032 Issued in TX
Practice address
604 N Rockwall Ave
Terrell, TX 75160-2117
Phone
(972) 522-8524
NPI assigned
Sep 3, 2007
Last updated
Apr 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N1032 TX Primary

Addresses

Primary practice location

604 N Rockwall Ave
Terrell, TX 75160-2117

Mailing address

18 Kestrel CT
Heath, TX 75032-2043
Phone (214) 675-3859

Other names 1

  • Dr. David Osagie Okumbor Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090304000195 TX Practitioner - Family PracticePractitioner - Internal Medicine 8921164773 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hunt Memorial Hospital DistrictGroup PAC ID 6406768936, 36 clinicians

Practice addresses (Care Compare)

4215 Joe Ramsey Blvd E
Greenville, TX 75401-7852
Phone (903) 408-5000

604 N Rockwall Ave
Terrell, TX 75160-2117
Phone (972) 522-8524

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hunt Memorial Hospital District Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Hunt Memorial Hospital District CurrentSince Jul 1, 2024 Accepting new patients
Avid Healthcare Services PA CurrentSince Mar 1, 2019 Accepting new patients
Glen Oaks Hospital, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Angelina Physician Services PA Past Accepting new patients
Texas Em-I Medical Services, PA Past Accepting new patients
Wheatland Inpatient Services Past Accepting new patients

Locations

301 Division St
Greenville, TX 75401
Phone (903) 453-3376

4215 Ramsey Blvd E
Greenville, TX 75401
Phone (903) 408-1470

604 N Rockwall Ave
Terrell, TX 75160
Phone (972) 522-8524

Interoperability endpoints

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1188777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1164616199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 KESTREL CT",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750322043",
            "telephone_number": "214-675-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ROCKWALL AVE",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751602117",
            "telephone_number": "972-522-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUMBOR",
        "first_name": "DAVID",
        "middle_name": "OSAGIE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-03",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "OKUMBOR",
            "middle_name": "OSAGIE",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Terrell, TX

Sources for this page

Verify at the official NPI Registry.