Individual provider Active NPI

Nanette Ariayefah Icho, M.D.

  • Family Medicine Physician
  • McKinney, TX
National Provider Identifier
1467656918
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8406 Issued in TX
Practice address
2745 Virginia Parkway
Suite 100
McKinney, TX 75071-4915
Phone
(214) 491-4900
Fax
(214) 496-4966
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N8406 TX Primary
Emergency Medicine Physician 207P00000X N8406 TX

Addresses

Primary practice location

2745 Virginia Parkway
Suite 100
McKinney, TX 75071-4915

Mailing address

2745 Virginia Parkway
Suite 100
McKinney, TX 75071-4915
Phone (214) 491-4900

Other practice location 1

1217 Florida Dr Ste 121
Arlington, TX 76015-2380
Phone (214) 491-4900

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000440 TX Practitioner - Family Practice 0749452795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1217 Florida Dr
Suite 121
Arlington, TX 76015-2380
Phone (214) 491-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Heights Family Medicine Clinic Family Medicine CurrentSince Nov 24, 2024 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Dec 14, 2011 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Dec 14, 2011 Accepting new patients
Emergis ER Coit, LLC Past Accepting new patients
Kiest Loop Trail Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

1217 Florida Dr
Ste 121
Arlington, TX 76015
Phone (214) 491-4900

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2745 Virginia Pkwy
Ste 100
McKinney, TX 75071
Phone (214) 491-4900

Interoperability endpoints

  • Direct secure messaging: nanette.icho@ohfmc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HFCJCA/Endpoint/HFCJCA

Organizations & group practices 6

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1467656918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 VIRGINIA PARKWAY",
            "address_2": "SUITE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750714915",
            "telephone_number": "214-491-4900",
            "fax_number": "214-496-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 VIRGINIA PARKWAY",
            "address_2": "SUITE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750714915",
            "telephone_number": "214-491-4900",
            "fax_number": "214-496-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1217 Florida Dr Ste 121",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760152380",
            "country_code": "US",
            "telephone_number": "214-491-4900",
            "fax_number": "214-491-4966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICHO",
        "first_name": "NANETTE",
        "middle_name": "ARIAYEFAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N8406",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N8406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.