Individual provider Active NPI

Naomi Nkundizanye, RN

  • Family Nurse Practitioner
  • Denton, TX
National Provider Identifier
1326792094
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1073263 Issued in TX
Practice address
2208 High Meadow Dr
Denton, TX 76208-7500
Phone
(940) 765-5149
NPI assigned
Feb 10, 2022
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 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 1073263 TX Primary

Addresses

Primary practice location

2208 High Meadow Dr
Denton, TX 76208-7500

Mailing address

P.O Box
Denton, TX 76208-7500

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
I20230927003310 TX Practitioner - Nurse Practitioner 5496109282 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1073263TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Holland MD PA CurrentSince Sep 13, 2023 Accepting new patients

Locations

800 Medical Center Dr
Ste C
Decatur, TX 76234
Phone (940) 626-2110

Organizations & group practices 1

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1326792094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762087500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 HIGH MEADOW DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762087500",
            "telephone_number": "940-765-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKUNDIZANYE",
        "first_name": "NAOMI",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.