Individual provider Active NPI

Pelumi Ayetigbo

  • Home Health Aide
  • Providence Village, TX
National Provider Identifier
1497664114
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2928 Pinecrest Dr
Providence Village, TX 76227-5888
Phone
(940) 365-6827
NPI assigned
Sep 7, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

2928 Pinecrest Dr
Providence Village, TX 76227-5888

Mailing address

2928 Pinecrest Dr
Providence Village, TX 76227-5888
Phone (940) 365-6827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1497664114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 PINECREST DR",
            "city": "PROVIDENCE VILLAGE",
            "state": "TX",
            "postal_code": "762275888",
            "telephone_number": "940-365-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 PINECREST DR",
            "city": "PROVIDENCE VILLAGE",
            "state": "TX",
            "postal_code": "762275888",
            "telephone_number": "940-365-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYETIGBO",
        "first_name": "PELUMI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.