Individual provider Active NPI

Egodi Agatha Onuoha

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1316550239
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1010860 Issued in TX
Practice address
10455 N Central Expy Ste 110
Dallas, TX 75231-2211
Phone
(469) 527-5824
NPI assigned
Aug 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1010860 TX Primary

Addresses

Primary practice location

10455 N Central Expy Ste 110
Dallas, TX 75231-2211

Mailing address

10455 N Central Expy Ste 110
Dallas, TX 75231-2211

Other practice location 1

5323 Harry Hines Boulevard Dallas
Dallas, TX 75390-0001
Phone (469) 856-3393

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
I20210212000284 TX Practitioner - Nurse Practitioner 4587079199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychcare of Dallas I PLLCGroup PAC ID 2466625371, 46 clinicians

Practice addresses (Care Compare)

4635 Southwest Fwy
Suite 635
Houston, TX 77027-7112
Phone 71385000491053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1010860TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centrum Medical Group PLLC CurrentSince Jun 1, 2023 Accepting new patients
Centrum Medical Group PLLC CurrentSince Jun 1, 2023 Accepting new patients
Centrum Medical Group, PLLC Current Accepting new patients
Senior Psychcare of Dallas I, PLLC CurrentSince Feb 3, 2021 Accepting new patients
Centrum Medical Group, PLLC PastSince Feb 1, 2022 Accepting new patients

Locations

9250 NW 36th St
Ste 420
Doral, FL 33178
Phone (786) 873-1805

4700 Little Rd
Arlington, TX 76017
Phone (817) 496-0766

128 W Belt Line Rd
Ste 1
Cedar Hill, TX 75104
Phone (469) 482-9646

2223 S Buckner Blvd
Dallas, TX 75227
Phone (972) 708-4000

10455 N Central Expy
Ste 110
Dallas, TX 75231
Phone (214) 540-0245

3410 President George Bush Tpke
Dallas, TX 75287
Phone (972) 619-6066

7664 McCart Ave
Fort Worth, TX 76133
Phone (817) 346-9700

5801 Golden Triangle Blvd
Ste 101
Fort Worth, TX 76244
Phone (214) 206-4706

1900 Oneal St
Gainesville, TX 76240
Phone (940) 665-2826

2380 Firewheel Pkwy
Ste 100
Garland, TX 75040
Phone (972) 864-0252

2355 E Grapevine Mills Cir
Ste 100
Grapevine, TX 76051

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

2450 N Belt Line Rd
Irving, TX 75062
Phone (336) 707-7843

1718 Highway 287 N
Ste 100
Mansfield, TX 76063
Phone (469) 684-7830

4200 Shepherd Ln
Mesquite, TX 75180
Phone (972) 286-0335

2698 N Galloway Ave
Ste 105
Mesquite, TX 75150
Phone (239) 465-2365

7146 Baker Blvd
Richland Hills, TX 76118
Phone (817) 589-1734

1029 N Saginaw Blvd
Ste E3
Saginaw, TX 76179
Phone (469) 343-1399

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1316550239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10455 N CENTRAL EXPY STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752312211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 N CENTRAL EXPY STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752312211",
            "telephone_number": "469-527-5824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Boulevard Dallas",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753900001",
            "country_code": "US",
            "telephone_number": "469-856-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUOHA",
        "first_name": "EGODI",
        "middle_name": "AGATHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1010860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.