Active NPI
Onongaya Cally Nwanyanwu
- Primary Care Nurse Practitioner
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- AP128064
- Practice address
- 10209 Black Hickory Rd
Dallas, TX 75243-5101 - Phone
- (214) 724-9449
- Fax
- (469) 330-1477
- NPI assigned
- Apr 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP128064 | TX | |
| Gerontology Nurse Practitioner | 363LG0600X | AP128064 | TX | |
| Primary Care Nurse Practitioner | 363LP2300X | AP128064 | TX | Primary |
Addresses
Primary practice location
10209 Black Hickory Rd
Dallas, TX 75243-5101
Mailing address
10209 Black Hickory Rd
Dallas, TX 75243-5101
Phone (214) 724-9449
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
- University of Cincinnati College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Dallas, TX 75238
Phone (972) 798-8001
2727 Lyndon B Johnson Fwy
Suite 212 9
Dallas, TX 75234-7334
Phone (214) 935-5777
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP128064 | TX | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Healthcare Network LLC | Current | Accepting new patients | |
| CSH Corp. | Current | Accepting new patients | |
| Highview Health Services LLC | Past | Accepting new patients | |
| Highview Health Services, LLC | Past | Accepting new patients |
Locations
10935 Estate Ln
#S427
Dallas, TX 75238
Phone (817) 350-7040
2727 Lyndon B Johnson Fwy
Ste 2129
Dallas, TX 75234
Phone (214) 935-5777
13509 Lyndon B Johnson Fwy
Ste 200
Garland, TX 75041
Phone (469) 898-3694
Organizations & group practices 4
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.
-
- General Practice Physician
- Dallas, TX
- NPI 1386518355
-
- Multi-Specialty Clinic/Center
- Dallas, TX
- NPI 1194368266
-
- Home Health Agency
- Duncanville, TX
- NPI 1053551762
-
- Home Health Agency
- Dallas, TX
- NPI 1750516407
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1386021186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10209 BLACK HICKORY RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752435101",
"telephone_number": "214-724-9449",
"fax_number": "469-330-1477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10209 BLACK HICKORY RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752435101",
"telephone_number": "214-724-9449",
"fax_number": "469-330-1477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWANYANWU",
"first_name": "ONONGAYA",
"middle_name": "CALLY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "AP128064",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "TX",
"license": "AP128064",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "AP128064",
"primary": true
}
],
"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 Apr 30, 2015; 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.