Individual provider Active NPI

Chidiogo Ebenmelu, AGNP-C

  • Adult Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1306318712
Registry record updated Apr 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG10180235 Issued in TX
Practice address
6220 Westpark Dr Ste 193
Houston, TX 77057-7371
Phone
(347) 869-2923
Fax
(281) 803-8174
NPI assigned
Dec 23, 2018
Last updated
Apr 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG10180235 TX Primary
Gerontology Nurse Practitioner 363LG0600X AG10180235 TX

Addresses

Primary practice location

6220 Westpark Dr Ste 193
Houston, TX 77057-7371

Mailing address

6220 Westpark Dr Ste 193
Houston, TX 77057-7371
Phone (347) 869-2923

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
I20231128001855 TX Practitioner - Nurse Practitioner 2466828421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KHS Geriatrics IncGroup PAC ID 9133427008, 9 clinicians
Ethos Wellness and Management LLCGroup PAC ID 4486003225, 2 clinicians

Practice addresses (Care Compare)

21014 Cordell Landing Dr
Richmond, TX 77407-4114
Phone (832) 646-0581

6220 Westpark Dr
Suite 193
Houston, TX 77057-7371
Phone (832) 203-7308

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG10180235TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Labs Texas LLC CurrentSince Apr 5, 2026 Accepting new patients
Beulah Health Care Services Inc Current Accepting new patients
KHS Geriatrics Inc Adult Health CurrentSince Nov 1, 2023 Accepting new patients
Dazetrin Services LLC CurrentSince Apr 11, 2021 Accepting new patients
Ethos Wellness & Management LLC CurrentSince Apr 5, 2026 Accepting new patients

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777161600000",
    "number": "1306318712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 WESTPARK DR STE 193",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770577371",
            "telephone_number": "347-869-2923",
            "fax_number": "281-803-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 WESTPARK DR STE 193",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770577371",
            "telephone_number": "347-869-2923",
            "fax_number": "281-803-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBENMELU",
        "first_name": "CHIDIOGO",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-23",
        "last_updated": "2026-04-26",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AG10180235",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AG10180235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.