Individual provider Active NPI

Nkiruka Virginia Mbonu

  • Primary Care Nurse Practitioner
  • Richmond, TX
National Provider Identifier
1487157327
Registry record updated Sep 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1137375 Issued in TX
Practice address
20003 Linden Spruce LN
Richmond, TX 77407-6908
Phone
(990) 390-3590
NPI assigned
Mar 16, 2018
Last updated
Sep 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1137375 TX Primary
Registered Nurse 163W00000X 939051 TX

Addresses

Primary practice location

20003 Linden Spruce LN
Richmond, TX 77407-6908

Mailing address

20003 Linden Spruce LN
Richmond, TX 77407-6908

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
I20231127002730 TX Practitioner - Nurse Practitioner 8820446107 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
939051TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vichek Health and Wellness LLC Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 13, 2023 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695427200000",
    "number": "1487157327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20003 LINDEN SPRUCE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774076908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20003 LINDEN SPRUCE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774076908",
            "telephone_number": "990-390-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONU",
        "first_name": "NKIRUKA",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2023-09-23",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1137375",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "939051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.