Individual provider Active NPI

Oluchi Ozumba, MD

  • Pain Medicine (Anesthesiology) Physician
  • Ennis, TX
National Provider Identifier
1659412591
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
Q0682 Issued in TX
Practice address
601 S Clay St Ste 104
Ennis, TX 75119-5771
Phone
(443) 418-4667
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MD435554 PA
Pain Medicine Physician 208VP0000X 47813 KY
Interventional Pain Medicine Physician 208VP0014X MD435554 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X Q0682 TX Primary

Addresses

Primary practice location

601 S Clay St Ste 104
Ennis, TX 75119-5771

Mailing address

752 N Main St Unit 1386
Mansfield, TX 76063-3293
Phone (443) 418-4667

Other practice location 1

1721 Nicholasville Rd
Sute 300
Lexington, KY 40503-1428
Phone (859) 252-6500

Other identifiers 1

IdentifierTypeStateIssuer
7100317560MedicaidKY

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
I20160531001009 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 7719021187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Wright State University Boonshoft School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oluchi Ozumba MD PAGroup PAC ID 0648606392, 3 clinicians

Practice addresses (Care Compare)

601 S Clay St
Suite 104
Ennis, TX 75119-5771
Phone (443) 418-4667

Hospital & facility affiliations

  • Medical City Arlington Hospital, Arlington, TX, CCN 450675
  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
  • Texas Health Arlington Memorial Hospital Hospital, Arlington, TX, CCN 450064
  • Texas Health Hospital Mansfield Hospital, Mansfield, TX, CCN 670309
  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0682TXMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vip Healthcare, PLLC CurrentSince May 10, 2016 Accepting new patients
Oluchi Ozumba MD PA Pain Medicine CurrentSince Sep 10, 2019 Accepting new patients
Carlisle Hma Physician Management, LLC PastSince Nov 13, 2016 Accepting new patients

Locations

601 S Clay St
Ste 104
Ennis, TX 75119
Phone (972) 875-6600

752 N Main St
Unit 1386
Mansfield, TX 76063

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1659412591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 N MAIN ST UNIT 1386",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633293",
            "telephone_number": "443-418-4667",
            "fax_number": "859-252-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S CLAY ST STE 104",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751195771",
            "telephone_number": "443-418-4667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Nicholasville Rd",
            "address_2": "Sute 300",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405031428",
            "country_code": "US",
            "telephone_number": "859-252-6500",
            "fax_number": "859-252-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OZUMBA",
        "first_name": "OLUCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD435554",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "KY",
            "license": "47813",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD435554",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "Q0682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100317560",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ennis, TX

Sources for this page

Verify at the official NPI Registry.