Norvelyn Tusil Tunacao Imbong

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

321-00-046 Issued in TX

Practice address

1201 S Main St
Fort Worth, TX 76104-4804

Phone

(817) 702-6500

NPI assigned

Aug 20, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1225915267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 HARDWOOD TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637582",
            "telephone_number": "817-965-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044804",
            "telephone_number": "817-702-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBONG",
        "first_name": "NORVELYN TUSIL",
        "middle_name": "TUNACAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "736359",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "TX",
            "license": "321-00-046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sandra K. Imes, M.D.
• Haivan Immler, PHARMD
• Timothy James Immonen, D.O.
• Impact Medical Services LLC
• Impactful Speech Therapy PLLC

• Diabetes Educator Registered Nurse in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Diabetes Educator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.