Grace Nwanne Igbudu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023019806 Issued in TX

Practice address

6777 Camp Bowie Blvd
Fort Worth, TX 76116-7155

Phone

(817) 670-4464

NPI assigned

Aug 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stonewell Behavioral PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
  • NPI 1134967441
  NPD Authorized official
• Raguel LLC

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1962373191
  Medicare reassignment

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1205518784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167155",
            "telephone_number": "682-900-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167155",
            "telephone_number": "817-670-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGBUDU",
        "first_name": "GRACE",
        "middle_name": "NWANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2023019806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idexpertcare PA
• Idk Technologies Corporation (B Health RX)
• Idmdtx, PLLC
• Oyinlola Idowu
• Ig Dental
• Fareed Enzo Ighani, DDS
• Jamshid H Ighani, D.O.
• Maha Ighanifard, DO
• Ebuwa Ighodaro, MD
• Kim A Iglesia, MD

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.