Gertrude Chinwe Madueke

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP-141066 Issued in TX

Practice address

150 Pine Forest Dr Ste 110
Shenandoah, TX 77384-5303

Phone

(281) 709-2555

Fax

(281) 440-9915

NPI assigned

Jul 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Trunic Classic Care LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Spring, TX
  • NPI 1659831741
  NPD Authorized official

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1629622691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20635 KUYKENDAHL RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PINE FOREST DR STE 110",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773845303",
            "telephone_number": "281-709-2555",
            "fax_number": "281-440-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUEKE",
        "first_name": "GERTRUDE",
        "middle_name": "CHINWE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP-141066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SHENANDOAH",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "150 Pine Forest Dr Ste 110",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773845303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heidi Lyn Stern, M.D.
• Mackenzie Lyons
• Madhavi Machineni, M.D
• Karen Lee Mackenney, RN, FNP
• Brooke D Madl, LCSW
• Vallery Mechell Magee, MD
• James Ryan Maggart, MD
• Shail Maheshwari, MD
• Sameera Mahmood, PHARMD
• Mahsa Mossadegh MD PLLC

• All providers in Shenandoah, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.