Esongnyuo Fomukong-Etta, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP131427 Issued in TX

Practice address

3050 Regent Blvd Ste 100
Irving, TX 75063-3107

Phone

(214) 689-8076

NPI assigned

Aug 23, 2016

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1255886909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9755",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772130755",
            "telephone_number": "832-717-2780",
            "fax_number": "832-717-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 REGENT BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633107",
            "telephone_number": "214-689-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMUKONG-ETTA",
        "first_name": "ESONGNYUO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP131427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flourish Physiatry
• Miranda Lee Flurry
• Sean Flynn
• FM Surgical Services
• Focus Imaging Inc
• Natalie Nicole Fontenot, FNP-C
• Michael Fooshee, D.D.S.
• Paul Forbang
• Ladonna Ford, FNP-C
• Cecily Forde

• Nurse Practitioner in Irving, TX
• Providers in Irving, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.