Active NPI
Shongerwi Chekenyere
- Psychiatric/Mental Health Nurse Practitioner
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1130132
- Practice address
- 601 W Terrell Ave
Fort Worth, TX 76104-3243 - Phone
- (817) 702-3100
- Fax
- (817) 702-4847
- NPI assigned
- Jul 5, 2022
- Last updated
- Aug 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1130132 | TX | Primary |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 954707 | TX | |
| Psychiatry Physician | 2084P0800X | 1130132 | TX |
Addresses
Primary practice location
601 W Terrell Ave
Fort Worth, TX 76104-3243
Mailing address
1708 Bardfield Ave
Garland, TX 75041-4921
Phone (817) 703-8313
Other practice location 1
1500 S Main St Fl 1
Fort Worth, TX 76104-4917
Phone (817) 702-3431
Other practice location 2
1500 S Main St Fl 2
Fort Worth, TX 76104-4917
Phone (817) 702-3636
Other practice location 3
1500 S Main St Fl 10
Fort Worth, TX 76104-4917
Phone (817) 702-4151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1130132 | Other | TX | BOARD OF NURSING LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 W Terrell Ave
Fort Worth, TX 76104-3243
Phone (817) 702-3100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.38 of 100
- Quality
- 80.41
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.69
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 954707 | TX | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| 1130132 | TX | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acclaim Physician Group, Inc | Current | Accepting new patients |
Locations
1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701
1500 S Main St
Fl 10
Fort Worth, TX 76104
Phone (817) 702-3636
1500 S Main St
Fl 1
Ft Worth, TX 76104
Phone (817) 702-1451
1500 S Main St
Fl 2
Ft Worth, TX 76104
Phone (817) 702-3000
200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450
601 W Terrell Ave
Ft Worth, TX 76104
Phone (817) 338-4333
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.
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1780076562
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba JPS Health Network
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1992753222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1376276618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 BARDFIELD AVE",
"city": "GARLAND",
"state": "TX",
"postal_code": "750414921",
"telephone_number": "817-703-8313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W TERRELL AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761043243",
"telephone_number": "817-702-3100",
"fax_number": "817-702-4847"
}
],
"practiceLocations": [
{
"address_1": "1500 S Main St Fl 1",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761044917",
"country_code": "US",
"telephone_number": "817-702-3431",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 S Main St Fl 2",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761044917",
"country_code": "US",
"telephone_number": "817-702-3636",
"fax_number": "817-927-8769",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 S Main St Fl 10",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761044917",
"country_code": "US",
"telephone_number": "817-702-4151",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHEKENYERE",
"first_name": "SHONGERWI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1130132",
"primary": true
},
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "TX",
"license": "954707",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "1130132",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF NURSING LICENSE",
"identifier": "1130132",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.