Individual provider Active NPI

Cedith Adelowo, FNP

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1225699572
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140752 Issued in TX
Practice address
200 N Carrier Pkwy Ste 100
Grand Prairie, TX 75050-5468
Phone
(972) 790-1200
NPI assigned
Jun 27, 2019
Last updated
Jun 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP140752 TX Primary

Addresses

Primary practice location

200 N Carrier Pkwy Ste 100
Grand Prairie, TX 75050-5468

Mailing address

4212 Coney Island Dr
Frisco, TX 75036-0691
Phone (817) 501-6991

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP140752TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1225699572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 CONEY ISLAND DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750360691",
            "telephone_number": "817-501-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N CARRIER PKWY STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505468",
            "telephone_number": "972-790-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELOWO",
        "first_name": "CEDITH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.