Individual provider Active NPI

Philomena Nwaokolo

  • Adult Health Nurse Practitioner
  • Garland, TX
National Provider Identifier
1427678762
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP145389 Issued in TX
Practice address
2205 Edinburgh Way
Garland, TX 75040-1139
Phone
(469) 767-4074
NPI assigned
Apr 16, 2020
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP145389 TX Primary

Addresses

Primary practice location

2205 Edinburgh Way
Garland, TX 75040-1139

Mailing address

2205 Edinburgh Way
Garland, TX 75040-1139
Phone (469) 767-4074

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
I20210105002524 TX Practitioner - Nurse Practitioner 4385670512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2205 Edinburgh Way
Garland, TX 75040-1139
Phone (469) 767-4074

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP145389TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vap Home Health Care, Inc. CurrentSince Apr 30, 2005 Accepting new patients
Vap Home Health Care, Inc. Current Accepting new patients
Legacy House Calls LLC Single Specialty CurrentSince Oct 2, 2020 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vap Home Health Care, Inc.Dallas, TX, CCN 677856 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director (100%)
W-2 Managing Employee
Apr 30, 2005
Apr 30, 2005
Apr 30, 2005
Apr 30, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1427678762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 EDINBURGH WAY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750401139",
            "telephone_number": "469-767-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 EDINBURGH WAY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750401139",
            "telephone_number": "469-767-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAOKOLO",
        "first_name": "PHILOMENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP145389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.