Individual provider Active NPI

Uchenna Iloma, FNP

  • Family Nurse Practitioner
  • Keller, TX
National Provider Identifier
1265957757
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134632 Issued in TX
Practice address
620 S Main St Ste 240
Keller, TX 76248-5009
Phone
(817) 912-8150
NPI assigned
Aug 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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 AP134632 TX Primary

Addresses

Primary practice location

620 S Main St Ste 240
Keller, TX 76248-5009

Mailing address

620 S Main St Ste 240
Keller, TX 76248-5009
Phone (817) 912-8150

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180314001528 TX Practitioner - Nurse Practitioner 4486916285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

610 E Byron Nelson Blvd
101 Baylor Scott and White Family Medicin
Roanoke, TX 76262-6547
Phone (817) 912-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
D&J Grace Team LLC CurrentSince Feb 1, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 27, 2022 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Jun 27, 2022 Accepting new patients
Healthtexas Provider Network PastSince Jun 27, 2022 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

921 FM 1187 E
Ste A
Crowley, TX 76036
Phone (817) 297-2000

921 FM 1187 E
Crowley, TX 76036
Phone (817) 297-2000

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

620 S Main St
Ste 240
Keller, TX 76248
Phone (817) 912-8150

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

610 E Byron Nelson Blvd
Ste 101
Roanoke, TX 76262
Phone (817) 912-8200

Interoperability endpoints

  • Direct secure messaging: uiloma1087459@direct.sw.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1265957757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S MAIN ST STE 240",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485009",
            "telephone_number": "817-912-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S MAIN ST STE 240",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485009",
            "telephone_number": "817-912-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILOMA",
        "first_name": "UCHENNA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.