Active NPI
Igho C Olobia, MD
- Pediatrics Physician
- Lewisville, TX
National Provider Identifier
1376517524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- K4178
- Practice address
- 541 W Main St Ste 110
Lewisville, TX 75057 - Phone
- (469) 702-6633
- Fax
- (469) 702-6636
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | K4178 | TX | Primary |
Addresses
Primary practice location
541 W Main St Ste 110
Lewisville, TX 75057
Mailing address
541 W Main St Ste 110
Lewisville, TX 75057-3628
Phone (469) 702-6633
Other practice location 1
541 W Main St Ste 110
Lewisville, TX 75057
Phone (469) 702-6633
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040592001 | Medicaid | TX | |
| 040592007 | Medicaid | TX |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acs Primary Care Physicians Southwest, PA | Past | Accepting new patients |
Interoperability endpoints
- igho.olobia.1@18695.direct.athenahealth.com
- https://api.platform.athenahealth.com/18695/brand/1/csg/1/fhir/r4
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.
-
- Emergency Medicine Physician
- Gainesville, TX
- NPI 1538101019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563753600000",
"number": "1376517524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 W MAIN ST STE 110",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573628",
"telephone_number": "469-702-6633",
"fax_number": "469-702-6636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 W MAIN ST STE 110",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "75057",
"telephone_number": "469-702-6633",
"fax_number": "469-702-6636"
}
],
"practiceLocations": [
{
"address_1": "541 W Main St Ste 110",
"address_purpose": "LOCATION",
"city": "Lewisville",
"state": "TX",
"postal_code": "75057",
"country_code": "US",
"telephone_number": "469-702-6633",
"fax_number": "469-702-6636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLOBIA",
"first_name": "IGHO",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2019-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "K4178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040592001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040592007",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.