Individual provider Active NPI

Michael Anda Njotu, PA

  • Physician Assistant
  • Haltom City, TX
National Provider Identifier
1679795900
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01216 Issued in TX
Practice address
4010 E Belknap St
Haltom City, TX 76111-6609
Phone
(817) 831-4300
Fax
(817) 831-4306
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01216 TX Primary

Addresses

Primary practice location

4010 E Belknap St
Haltom City, TX 76111-6609

Mailing address

2200 Delaford Dr
Arlington, TX 76002-3859
Phone (817) 793-4571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1679795900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 DELAFORD DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760023859",
            "telephone_number": "817-793-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 E BELKNAP ST",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761116609",
            "telephone_number": "817-831-4300",
            "fax_number": "817-831-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJOTU",
        "first_name": "MICHAEL",
        "middle_name": "ANDA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haltom City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.