Individual provider Active NPI

Joy Adaku Ekwueme, FNP

  • Family Nurse Practitioner
  • Shenandoah, TX
National Provider Identifier
1609373992
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
729822 Issued in TX
Practice address
Main Street Medical Clinic
1120 Medical Plaza Dr, Suite 335
Shenandoah, TX 77380
Phone
(281) 528-4102
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 729822 TX Primary

Addresses

Primary practice location

Main Street Medical Clinic
1120 Medical Plaza Dr, Suite 335
Shenandoah, TX 77380

Mailing address

Alief Geriatrics Associates, PA
1801 N. Loop West, Suite 40
Houston, TX 77008
Phone (713) 416-2229

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

State licenses

LicenseStateTypeSpecialty
729822TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1609373992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALIEF GERIATRICS ASSOCIATES, PA",
            "address_2": "1801 N. LOOP WEST, SUITE 40",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77008",
            "telephone_number": "713-416-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIN STREET MEDICAL CLINIC",
            "address_2": "1120 MEDICAL PLAZA DR, SUITE 335",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-528-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKWUEME",
        "first_name": "JOY",
        "middle_name": "ADAKU",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "729822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.