Individual provider Active NPI

Liby Shibu Varghese, AGACNP

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1447878434
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1002443 Issued in TX
Practice address
6400 Fannin St Ste 2800
Houston, TX 77030-1534
Phone
(713) 486-8000
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1002443 TX Primary

Addresses

Primary practice location

6400 Fannin St Ste 2800
Houston, TX 77030-1534

Mailing address

6400 Fannin St Ste 2070
Houston, TX 77030-1541
Phone (281) 904-5650

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
I20200817000490 TX Practitioner - Nurse Practitioner 5294151684 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1002443TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 21, 2024 Accepting new patients

Locations

6400 Fannin St
Ste 2070
Houston, TX 77030
Phone (713) 704-6731

6400 Fannin St
Ste 2800
Houston, TX 77030
Phone (713) 704-7100

6410 Fannin St
Ste LL135
Houston, TX 77030
Phone (832) 325-6543

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

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.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1447878434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2070",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301541",
            "telephone_number": "281-904-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301534",
            "telephone_number": "713-486-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "LIBY",
        "middle_name": "SHIBU",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1002443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.