NPIMap

Individual provider Active NPI

Zainabu Koroma, FNP

  • Family Nurse Practitioner
  • Garland, TX
National Provider Identifier
1699053553
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
647352 Issued in TX
Practice address
3334 Broadway Blvd
Ste 422
Garland, TX 75043-1575
Phone
(972) 979-7408
Fax
(972) 587-6733
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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 647352 TX Primary

Addresses

Primary practice location

3334 Broadway Blvd
Ste 422
Garland, TX 75043-1575

Mailing address

3334 Broadway Blvd
Ste 422
Garland, TX 75043-1575
Phone (972) 677-7564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110921000840 TX Practitioner - Nurse Practitioner 4981797248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Visiting Clinicians PLLCGroup PAC ID 2668785791, 4 clinicians

Practice addresses (Care Compare)

3334 Broadway Blvd
Suite 422
Garland, TX 75043-1575
Phone (972) 979-7408

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
647352TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Visiting Clinicians PLLC Family CurrentSince Jun 18, 2015 Accepting new patients
Hardeep Rai, MD, PA CurrentSince Apr 29, 2013 Accepting new patients
Srilatha a. Reddy, M.D., P.a PastSince Oct 15, 2001 Accepting new patients
Physicians and Allied Health Professionals Group, PA PastSince Apr 29, 2013 Accepting new patients
Leone Homehealth Care Agency Inc. Past Accepting new patients

Locations

1913 Walnut Plz
Carrollton, TX 75006
Phone (972) 416-5902

3334 Broadway Blvd
Ste 422
Garland, TX 75043
Phone (972) 271-1156

3129 Interstate 30
Ste H
Mesquite, TX 75150
Phone (214) 227-2510

Interoperability endpoints

  • Direct secure messaging: zainabu.koroma@pvc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDCBD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A4Z Home Health CareGarland, TX, CCN 747050 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Director
W-2 Managing Employee		 Sep 4, 2006
Sep 4, 2006
Nov 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 3

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1699053553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 BROADWAY BLVD",
            "address_2": "STE 422",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431575",
            "telephone_number": "972-677-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 BROADWAY BLVD",
            "address_2": "STE 422",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431575",
            "telephone_number": "972-979-7408",
            "fax_number": "972-587-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "ZAINABU",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "647352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.