Individual provider Active NPI

Irene Mugo

  • Nurse's Aide
  • Keller, TX
National Provider Identifier
1194303164
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
NA0060050642 Issued in TX
Practice address
1150 Whitley Rd
Keller, TX 76248-3038
Phone
(817) 431-2518
NPI assigned
Mar 31, 2021
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NA0060050642 TX Primary

Addresses

Primary practice location

1150 Whitley Rd
Keller, TX 76248-3038

Mailing address

13225 Settlers TRL
Fort Worth, TX 76244-5706
Phone (919) 384-5393

Other identifiers 1

IdentifierTypeStateIssuer
NA0060050642OtherTXCNA CERTIFICATE

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

State licenses

LicenseStateTypeSpecialty
NA0060050642TXMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1194303164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13225 SETTLERS TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445706",
            "telephone_number": "919-384-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 WHITLEY RD",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483038",
            "telephone_number": "817-431-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGO",
        "first_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "TX",
            "license": "NA0060050642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNA CERTIFICATE",
            "identifier": "NA0060050642",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.