Individual provider Active NPI

Elizabeth Chinyere Ogbonna

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1306412192
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1045643 Issued in TX
Practice address
6363 N State Highway 161 Ste 100
Irving, TX 75038-2239
Phone
(469) 200-3272
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 1045643 TX Primary

Addresses

Primary practice location

6363 N State Highway 161 Ste 100
Irving, TX 75038-2239

Mailing address

4913 Treeside Dr
Fort Worth, TX 76123-2948
Phone (806) 626-1619

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)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: eogbonna@landmarkhealth-direct.org

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1306412192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 TREESIDE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232948",
            "telephone_number": "806-626-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 N STATE HIGHWAY 161 STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382239",
            "telephone_number": "469-200-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBONNA",
        "first_name": "ELIZABETH",
        "middle_name": "CHINYERE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1045643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.