Individual provider Active NPI

Onongaya Cally Nwanyanwu

  • Primary Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1386021186
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP128064 Issued in TX
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

Updated by the provider on Apr 30, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001226 TX Practitioner - Nurse Practitioner 5193747368 Reassigns benefits to 2 organizations

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
CSH Corp.Group PAC ID 5395234199, 15 clinicians

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

LicenseStateTypeSpecialty
AP128064TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Healthcare Network LLC CurrentSince Sep 1, 2020 Accepting new patients
CSH Corp. CurrentSince Oct 2, 2025 Accepting new patients
Highview Health Services LLC Past Accepting new patients
Highview Health Services, LLC PastSince Jul 21, 2010 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.

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

Verify at the official NPI Registry.