NPIMap

Individual provider Active NPI

Victoria K. Nwosu, MD

  • Neurology Physician
  • Fort Worth, TX
National Provider Identifier
1558449603
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
P4216 Issued in TX
Practice address
1307 8TH Ave Ste 608
Fort Worth, TX 76104-4109
Phone
(817) 921-4191
Fax
(817) 926-6045
NPI assigned
Nov 2, 2006
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2009-00917 NC
Neurology Physician 2084N0400X LL28084 SC
Neurology Physician 2084N0400X P4216 TX Primary

Addresses

Primary practice location

1307 8TH Ave Ste 608
Fort Worth, TX 76104-4109

Mailing address

1307 8TH Ave Ste 608
Fort Worth, TX 76104-4140
Phone (817) 921-4191

Other identifiers 2

IdentifierTypeStateIssuer
3095101MedicaidTX
547906ZXU5OtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121022000439 TX Practitioner - Neurology 5597811406 Reassigns benefits to 1 organization
I20230628000372 NE Practitioner - Neurology 5597811406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Tulane University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Neuroscience PAGroup PAC ID 5991737926, 3 clinicians
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

1307 8TH Ave
Suite 608
Fort Worth, TX 76104-4109
Phone (817) 921-4191

350 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 717-5390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-00917NCMDNeurology Physician
LL28084SCMDNeurology Physician
P4216TXMDNeurology Physician
00917NCMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jun 15, 2023 Accepting new patients
Clinical Neuroscience PA Neurology CurrentSince Nov 14, 2016 Accepting new patients
DFW Neurology PLLC Neurology PastSince Aug 1, 2015 Accepting new patients
Cleveland Health Ventures LLC Neurology Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7710 Mercy Rd
Ste 3000
Omaha, NE 68124
Phone (402) 717-9600

1307 8th Ave
Ste 408
Ft Worth, TX 76104
Phone (800) 650-4990

1307 8th Ave
Ste 608
Ft Worth, TX 76104
Phone (817) 921-4191

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9382/brand/1/csg/1/fhir/r4
  • Direct secure messaging: victoria.nwosu.1@9382.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1558449603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE STE 608",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044140",
            "telephone_number": "817-921-4191",
            "fax_number": "817-926-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE STE 608",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044109",
            "telephone_number": "817-921-4191",
            "fax_number": "817-926-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "VICTORIA",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2009-00917",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "LL28084",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "P4216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "547906ZXU5",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.