Individual provider Active NPI

Grace Chinenye Igwebuike

  • Physical Therapist
  • Humble, TX
National Provider Identifier
1538767348
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1337410 Issued in TX
Practice address
19424 McKay Dr
Humble, TX 77338-5706
Phone
(281) 319-4060
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1337410 TX Primary

Addresses

Primary practice location

19424 McKay Dr
Humble, TX 77338-5706

Mailing address

6200 Renwick Dr Apt 474
Houston, TX 77081-3850
Phone (832) 417-4792

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1337410TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adaptive Rehabilitation Clinics, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1538767348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 RENWICK DR APT 474",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770813850",
            "telephone_number": "832-417-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19424 MCKAY DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385706",
            "telephone_number": "281-319-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGWEBUIKE",
        "first_name": "GRACE",
        "middle_name": "CHINENYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1337410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.