Individual provider Active NPI

Ehiozogie Adu Osayimwen, D.O

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1477937431
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10053240 Issued in TX
Practice address
900 8TH Ave
Fort Worth, TX 76104-3902
Phone
(817) 877-5292
NPI assigned
Jul 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10053240 TX Primary

Addresses

Primary practice location

900 8TH Ave
Fort Worth, TX 76104-3902

Mailing address

3901 W 15TH St
Plano, TX 75075-7738
Phone (972) 519-1530

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
I20181114000460 TX Practitioner - Internal Medicine 3870847643 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10053240TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Hospitalists PLLC Internal Medicine CurrentSince Sep 3, 2018 Accepting new patients
Columbia Medical Center of Plano Subsidiary LP Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

1950 Record Crossing Rd
Dallas, TX 75235
Phone (214) 638-1500

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

2301 Marsh Ln
Plano, TX 75093
Phone (972) 428-1600

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Organizations & group practices 2

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": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1477937431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 W 15TH ST",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757738",
            "telephone_number": "972-519-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "817-877-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADU OSAYIMWEN",
        "first_name": "EHIOZOGIE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-18",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10053240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.