Individual provider Active NPI

Anthonia Nwanna, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Missouri City, TX
National Provider Identifier
1689083875
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126217 Issued in TX
Practice address
4006 Creek Ridge LN
Missouri City, TX 77459-2342
Phone
(713) 482-9542
Fax
(281) 403-1945
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP126217 TX Primary

Addresses

Primary practice location

4006 Creek Ridge LN
Missouri City, TX 77459-2342

Mailing address

4006 Creek Ridge LN
Missouri City, TX 77459-2342

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171201000285 TX Practitioner - Nurse Practitioner 3476810375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9207 Country Creek Dr
Suite 105
Houston, TX 77036-7745
Phone (281) 888-9458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP126217TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Surehealth Clinic LLC CurrentSince Nov 8, 2017 Accepting new patients
Destiny Family and Pediatric Clinic Past Accepting new patients

Locations

9207 Country Creek Dr
Ste 105
Houston, TX 77036
Phone (281) 747-9669

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1689083875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 CREEK RIDGE LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 CREEK RIDGE LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592342",
            "telephone_number": "713-482-9542",
            "fax_number": "281-403-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANNA",
        "first_name": "ANTHONIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.