Mobolanle A. Fagbemi, APRN. FNP-C, CPNP-PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP119341 Issued in TX

Practice address

450 N 11TH St
Beaumont, TX 77702-1804

Phone

(832) 548-5000

NPI assigned

Sep 13, 2011

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gulf Coast Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Port Arthur, TX
  • NPI 1912904897
  Medicare reassignment
• Cornerstone Family Health Center PLLC

  • Primary Care Clinic/Center
  • Beaumont, TX
  • NPI 1407256472
  NPD (past) Authorized official
• Gulf Coast Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Port Arthur, TX
  • NPI 1205275054
  NPD

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1497037725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N 11TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021804",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBEMI",
        "first_name": "MOBOLANLE",
        "middle_name": "A.",
        "credential": "APRN. FNP-C, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP119341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP119341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express, LTD.
• Eyemasters of Texas, LTD. (EyeMasters)
• Desire Ebot Eyong, PHARM.D
• Ezea D. Ede MD (Ochendu Medical Clinic PA)
• Elias N Ezike, MD
• Elizabeth Fair
• Fallon T Gordon MD PA
• Dean Fam, M.D.
• Family and Friends Care Center
• Family Home Healthcare

• Family Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.