Evelyn Ebere Ukadike, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022014834 Issued in MO

Practice address

12801 Keystone Dr
Balch Springs, TX 75180

Phone

(469) 878-6318

Fax

(214) 772-6226

NPI assigned

Oct 1, 2009

Last updated

Sep 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Star Legacy Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
  • NPI 1104409010

  TX

  Medicare reassignment NPD
• New Dawn Homehealh Services Inc

  • Home Health Agency
  • Balch Springs, TX
  • NPI 1083949192
  NPD (past) Authorized official
• New Dawn Home Health Services

  • Home Health Agency
  • Balch Springs, TX
  • NPI 1669770269
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1386978781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042879",
            "telephone_number": "417-347-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 KEYSTONE DR",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "75180",
            "telephone_number": "469-878-6318",
            "fax_number": "214-772-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKADIKE",
        "first_name": "EVELYN",
        "middle_name": "EBERE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2022014834",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "TX",
            "license": "801108670",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violet Stone
• Issifu Tenii
• Texas Post Acute Specialists, PA
• Texas Time Healthcare
• Trang Nguyen, OD, PA
• Niyanta Vyas
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-1118)
• Wal-Mart Stores Texas, LP (Vision Center 30-1118)
• Jordyn Waldrip
• Averil Lanan Walker

• Psychiatric/Mental Health Nurse Practitioner in Balch Springs, TX
• Providers in Balch Springs, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.

Verify at the official NPI Registry.