Individual provider Active NPI

Isaac Erhiga Otitigbe, LVN

  • Licensed Vocational Nurse
  • Plano, TX
National Provider Identifier
1689174450
Registry record updated Feb 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
220528 Issued in TX
Practice address
190 Ashwood Cir
Plano, TX 75075-8951
Phone
(214) 779-5258
NPI assigned
Feb 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 220528 TX Primary

Addresses

Primary practice location

190 Ashwood Cir
Plano, TX 75075-8951

Mailing address

190 Ashwood Cir
Plano, TX 75075-8951
Phone (214) 779-5258

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
220528TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1518912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518912000000",
    "number": "1689174450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ASHWOOD CIR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758951",
            "telephone_number": "214-779-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ASHWOOD CIR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758951",
            "telephone_number": "214-779-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTITIGBE",
        "first_name": "ISAAC",
        "middle_name": "ERHIGA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-18",
        "last_updated": "2018-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "220528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2018; 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.