Organization Active NPI

Win Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1376250613
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WIN PSYCHIATRY
Practice address
4407 Emerald Leaf Dr
Mansfield, TX 76063-5545
Phone
(443) 600-8858
Fax
(817) 225-2492
NPI assigned
Nov 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Authorized official

Name
Henry Ehizokhale, MSN, APRN, PMHNP-BCNPI 1205593852
Title
Owner of Entity
Phone
(443) 600-8858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4407 Emerald Leaf Dr
Mansfield, TX 76063-5545

Mailing address

4407 Emerald Leaf Dr
Mansfield, TX 76063-5545
Phone (443) 600-8858

Other practice location 1

424 W Bakerview Rd Ste 105-2092
Bellingham, WA 98226-8176
Phone (443) 600-8858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130002094 TX Part B Supplier - Clinic/Group Practice 9234507997 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

1900 Matlock Rd
Ste 804
Mansfield, TX 76063
Phone (682) 400-8537

424 W Bakerview Rd
Ste 1052092
Bellingham, WA 98226
Phone (443) 600-8858

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1376250613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 EMERALD LEAF DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635545",
            "telephone_number": "443-600-8858",
            "fax_number": "817-225-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 EMERALD LEAF DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635545",
            "telephone_number": "443-600-8858",
            "fax_number": "817-225-2492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 W Bakerview Rd Ste 105-2092",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982268176",
            "country_code": "US",
            "telephone_number": "443-600-8858",
            "fax_number": "817-225-2492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WIN PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "EHIZOKHALE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "443-600-8858",
        "authorized_official_credential": "MSN, APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.