Individual provider Active NPI

Hermine R Ariyibi, NP

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1568615417
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
600383 Issued in TX
Practice address
221 W Colorado Blvd
Pavillion I, Suite 108
Dallas, TX 75208-2363
Phone
(214) 941-3192
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 600383 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd
Pavillion I, Suite 108
Dallas, TX 75208-2363

Mailing address

221 W Colorado Blvd
Pavillion I, Suite 108
Dallas, TX 75208-2363
Phone (214) 941-3192

Other identifiers 3

IdentifierTypeStateIssuer
207847902MedicaidTX
207847901MedicaidTX
207847903MedicaidTX

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
I20090218000316 TX Practitioner - Nurse Practitioner 3072678424 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Dirnberger DO PA Current Accepting new patients
Regency Pain, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients
Comprehensive Medical Services of Texas,LLC Past Accepting new patients

Locations

16970 Dallas Pkwy
Ste 500
Dallas, TX 75248
Phone (972) 248-1303

74 Regency Pkwy
Mansfield, TX 76063
Phone (817) 419-6111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCAICD
  • Direct secure messaging: hermine.ariyibi.1@11201.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11201/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1568615417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "address_2": "PAVILLION I, SUITE 108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-941-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "address_2": "PAVILLION I, SUITE 108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-941-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIYIBI",
        "first_name": "HERMINE",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "600383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207847902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207847901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207847903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.