Theresa Chibuoke, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1115822 Issued in TX

Practice address

2131 Kirkwood Blvd Ste 100
Southlake, TX 76092-1540

Phone

(817) 251-4906

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY, 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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Timely Psychiatry and Family Health NP PracticeGroup PAC ID 8628433414, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timely Psychiatry and Family Health NP Practice

  dba Timely Psychiatry

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hempstead, NY
  • NPI 1659090603
  Medicare reassignment Care Compare group NPD
• Still Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southlake, TX
  • NPI 1366183139
  Medicare reassignment NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1679251557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 KIRKWOOD BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921529",
            "telephone_number": "817-251-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 KIRKWOOD BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921540",
            "telephone_number": "817-251-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIBUOKE",
        "first_name": "THERESA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1115822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles B Russey (Acute Care and Family Medicine)
• Kelly Lynn Cheatham, PHD, LPC-S
• Sally Chee Spieldenner, PT
• Miranda K Cheib, C-NP
• David Shie Chiang, OD
• Chiro One Wellness Center of South Lake PLLC
• Chiropractic Care Center of Southlake, P.C.
• Taylor Ann Chishom, MD MPH
• Hardik Chodavadia, DDS
• Choice Diagnostic Lab (Solaris Diagnostics)

• Psychiatric/Mental Health Nurse Practitioner in Southlake, TX
• Providers in Southlake, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.