Individual provider Active NPI

Hyginus Ihenacho Obinwanne, REGISTERED NURSE

  • Registered Nurse
  • Dallas, TX
National Provider Identifier
1336399484
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
759554 Issued in TX
Practice address
2514 Community Dr Apt 216
Dallas, TX 75220-5570
Phone
(214) 654-0155
NPI assigned
Sep 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 759554 TX Primary
Registered Nurse 163W00000X 499985 CA

Addresses

Primary practice location

2514 Community Dr Apt 216
Dallas, TX 75220-5570

Mailing address

2514 Community Dr Apt 216
Dallas, TX 75220-5570
Phone (214) 654-0155

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
499985CAMDRegistered Nurse
759554TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Venus Healthcare Incorpoation Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1336399484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 COMMUNITY DR APT 216",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752205570",
            "telephone_number": "214-654-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 COMMUNITY DR APT 216",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752205570",
            "telephone_number": "214-654-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBINWANNE",
        "first_name": "HYGINUS",
        "middle_name": "IHENACHO",
        "name_prefix": "Mr.",
        "credential": "REGISTERED  NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "759554",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "499985",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Sep 25, 2008; 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.