Organization Active NPI

Good4U Family Clinic Dallas Fort Worth Dfwpllc

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1629609060
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC
Practice address
1417 N Cockrell Hill Rd Ste 101a
Dallas, TX 75211-1308
Phone
(214) 228-5447
Fax
(469) 778-0124
NPI assigned
Feb 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Chibuzor Ngwakwe
Title
Manager
Phone
(214) 228-5447

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0300X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1417 N Cockrell Hill Rd Ste 101a
Dallas, TX 75211-1308

Mailing address

1417 N Cockrell Hill Rd Ste 106
Dallas, TX 75211-1430
Phone (214) 228-5447

Other identifiers 2

IdentifierTypeStateIssuer
803342054OtherTXSTATE OF TEXAS
803342054MedicaidTX

Other names 1

  • Good4u Family Clinic Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2241916Good4U Family Clinic DFW, PLLC1417 N Cockrell Hill Rd Suite 106, Dallas, TX 75211Certificate of waiverNov 2, 2027

National Provider Directory

National Provider Directory

Locations

1417 N Cockrell Hill Rd
Ste 106
Dallas, TX 75211

1417 N Cockrell Hill Rd
Ste 101A
Dallas, TX 75211
Phone (469) 774-0124

NPI Registry JSON

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1629609060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N COCKRELL HILL RD STE 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752111430",
            "telephone_number": "214-228-5447",
            "fax_number": "469-778-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N COCKRELL HILL RD STE 101A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752111308",
            "telephone_number": "214-228-5447",
            "fax_number": "469-778-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD4U FAMILY CLINIC DALLAS FORT WORTH DFWPLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "NGWAKWE",
        "authorized_official_first_name": "CHIBUZOR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-228-5447"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "803342054",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803342054",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good4u Family Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Good4u Family Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.