Individual provider Active NPI

Ifeyinwa Peggy Eribenne, DNP

  • Family Nurse Practitioner
  • Katy, TX
National Provider Identifier
1609490168
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95014819 Issued in CA
Practice address
3822 Colorado Bend Dr
Katy, TX 77494-5466
Phone
(919) 995-5789
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142057 TX
Family Nurse Practitioner 363LF0000X NP95014819 CA Primary

Addresses

Primary practice location

3822 Colorado Bend Dr
Katy, TX 77494-5466

Mailing address

3822 Colorado Bend Dr
Katy, TX 77494-5466
Phone (919) 995-5789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260428003183 CO Practitioner - Nurse Practitioner 5092282970 Reassigns benefits to 1 organization
I20260428003198 TX Practitioner - Nurse Practitioner 5092282970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of the Incarnate Word School of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Exelon Health Management LLCGroup PAC ID 0143704478, 6 clinicians

Practice addresses (Care Compare)

9304 Forest LN
Suite S145
Dallas, TX 75243-6238
Phone (469) 809-4979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP142057TXMDFamily Nurse Practitioner

Organizations & group practices 2

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": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1609490168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 COLORADO BEND DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945466",
            "telephone_number": "919-995-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 COLORADO BEND DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945466",
            "telephone_number": "919-995-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIBENNE",
        "first_name": "IFEYINWA",
        "middle_name": "PEGGY",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142057",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95014819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.