Individual provider Active NPI

Yamamah Mohammad Isa, WHCNP

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1336347954
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
654555 Issued in TX
Practice address
8224 Park LN Ste 130
Vickery Health Center
Dallas, TX 75231-6021
Phone
(214) 266-0350
NPI assigned
Jul 5, 2007
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 654555 TX Primary

Addresses

Primary practice location

8224 Park LN Ste 130
Vickery Health Center
Dallas, TX 75231-6021

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 10

IdentifierTypeStateIssuer
196040308MedicaidTX
196040305MedicaidTX
196040309MedicaidTX
196040306MedicaidTX
196040307MedicaidTX
196040310MedicaidTX
196040301MedicaidTX
196040303MedicaidTX
196040302MedicaidTX
8Y2336OtherTXBLUE CROSS BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
654555TXMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1336347954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8224 PARK LN STE 130",
            "address_2": "VICKERY HEALTH CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752316021",
            "telephone_number": "214-266-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISA",
        "first_name": "YAMAMAH",
        "middle_name": "MOHAMMAD",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "654555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040308",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040305",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040309",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040306",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040310",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196040302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y2336",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.