Individual provider Active NPI

Ashley Mani Sisoumphou

  • Registered Nurse
  • Houston, TX
National Provider Identifier
1255807921
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
947627 Issued in TX
Practice address
13119 Woodington Dr
Houston, TX 77038-1624
Phone
(832) 497-7621
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 947627 TX Primary

Addresses

Primary practice location

13119 Woodington Dr
Houston, TX 77038-1624

Mailing address

13119 Woodington Dr
Houston, TX 77038-1624

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
947627TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1255807921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13119 WOODINGTON DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770381624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13119 WOODINGTON DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770381624",
            "telephone_number": "832-497-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISOUMPHOU",
        "first_name": "ASHLEY",
        "middle_name": "MANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "947627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.