Individual provider Active NPI

Kim Nguyen Onufrak, D.O.

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1619319571
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP10047017 Issued in TX
Practice address
4818 Holly Rd
Suite a
Corpus Christi, TX 78411-4734
Phone
(361) 993-1747
NPI assigned
Jul 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10047017 TX Primary

Addresses

Primary practice location

4818 Holly Rd
Suite a
Corpus Christi, TX 78411-4734

Mailing address

14202 Encantada Ave
Apt 701
Corpus Christi, TX 78418-6636
Phone (214) 558-8919

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170411001885 TX Practitioner - Family Practice 3678858065 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10047017TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guadalupe Emergency Medicine Associates, PA CurrentSince Feb 2, 2020 Accepting new patients

Locations

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

Organizations & group practices 1

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": "1374278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1619319571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14202 ENCANTADA AVE",
            "address_2": "APT 701",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186636",
            "telephone_number": "214-558-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 HOLLY RD",
            "address_2": "SUITE A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114734",
            "telephone_number": "361-993-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONUFRAK",
        "first_name": "KIM",
        "middle_name": "NGUYEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-20",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10047017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.