Individual provider Active NPI

Joseph Peter Isibor, FNP

  • Family Nurse Practitioner
  • Missouri City, TX
National Provider Identifier
1376108365
Registry record updated May 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141411 Issued in TX
Practice address
4204 Stonebridge Dr
Missouri City, TX 77459-3264
Phone
(913) 742-3745
NPI assigned
May 5, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2019

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 AP141411 TX Primary

Addresses

Primary practice location

4204 Stonebridge Dr
Missouri City, TX 77459-3264

Mailing address

4204 Stonebridge Dr
Missouri City, TX 77459-3264

Other identifiers 1

IdentifierTypeStateIssuer
AP141411OtherTXFAMILY NURSE PRACTITIONER

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
I20210916000557 TX Practitioner - Nurse Practitioner 8628475746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP141411TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Bay Clinic and Wellness CurrentSince Aug 1, 2021 Accepting new patients

Locations

11420 Dairy Ashford Rd
Ste 104
Sugar Land, TX 77478
Phone (713) 485-0763

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": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557014400000",
    "number": "1376108365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 STONEBRIDGE DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 STONEBRIDGE DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593264",
            "telephone_number": "913-742-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIBOR",
        "first_name": "JOSEPH",
        "middle_name": "PETER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-05",
        "last_updated": "2019-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "AP141411",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.