Individual provider Active NPI

Obinna Chris Okereke, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1174002349
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP138427 Issued in TX
Practice address
2100 N State Hyw 360
2100 A
Grand Prairie, TX 75050-7505
Phone
(214) 677-0618
NPI assigned
Aug 8, 2018
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP138427 TX Primary

Addresses

Primary practice location

2100 N State Hyw 360
2100 A
Grand Prairie, TX 75050-7505

Mailing address

1315 Thunder Dove Dr
Mansfield, TX 76063-6548
Phone (817) 899-6284

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
I20181031001979 TX Practitioner - Nurse Practitioner 5294977450 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2100 N Hwy 360
Suite 2100a
Grand Prairie, TX 75050-1042
Phone (682) 331-5511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP138427TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hawkins Psychiatry PC CurrentSince Aug 13, 2018 Accepting new patients
Dallas County Mental Health & Mental Retardation Center CurrentSince Jan 7, 2019 Accepting new patients
Apex Behavioral Health LLC Psychiatric/Mental Health CurrentSince Dec 1, 2020 Accepting new patients
Hope Starts Here LLC PastSince Nov 12, 2023 Accepting new patients

Locations

2233 Avenue J
Ste 101
Arlington, TX 76006
Phone (817) 385-0088

1345 River Bend Dr
Ste 200
Dallas, TX 75247
Phone (469) 899-3200

2100 N State Highway 360
Ste 2100A
Grand Prairie, TX 75050
Phone (214) 677-0618

503 W Harwood Rd
Hurst, TX 76054
Phone (817) 268-4404

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1174002349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 THUNDER DOVE DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636548",
            "telephone_number": "817-899-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N STATE HYW 360",
            "address_2": "2100 A",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750507505",
            "telephone_number": "214-677-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "OBINNA",
        "middle_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP138427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.