Individual provider Active NPI

Patrick U Ikechukwu, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1598466872
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
111256 Issued in TX
Practice address
1125 Cypress Station Dr Ste B-1
Houston, TX 77090-3055
Phone
(281) 586-7880
Fax
(281) 580-5061
NPI assigned
Mar 14, 2023
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 111256 TX Primary

Addresses

Primary practice location

1125 Cypress Station Dr Ste B-1
Houston, TX 77090-3055

Mailing address

1125 Cypress Station Dr Ste B-1
Houston, TX 77090-3055
Phone (281) 586-7880

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
111256TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1598466872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CYPRESS STATION DR STE B-1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903055",
            "telephone_number": "281-586-7880",
            "fax_number": "281-580-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CYPRESS STATION DR STE B-1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903055",
            "telephone_number": "281-586-7880",
            "fax_number": "281-580-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKECHUKWU",
        "first_name": "PATRICK",
        "middle_name": "U",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "111256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.