Individual provider Active NPI

Geoffrey Iheukwumere Nzeadibe

  • Home Health Aide
  • Garland, TX
National Provider Identifier
1720149982
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
3960 Broadway Blvd Ste 230
Garland, TX 75043-2591
Phone
(972) 303-2800
Fax
(469) 442-0647
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Supports Brokerage Agency 251X00000X
Home Health Aide 374U00000X Primary
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

3960 Broadway Blvd Ste 230
Garland, TX 75043-2591

Mailing address

4510 Horizon Dr
Garland, TX 75043-1869
Phone (972) 303-2800

Other practice location 1

4510 Horizon Dr
Garland, TX 75043-1869
Phone (972) 303-2800

Other names 1

  • Lucky Enterprise Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lucky Enterprise Case Management Current Accepting new patients
Calmcare Behavioral and Wellness Center LLC Single Specialty CurrentSince Feb 23, 2025 Accepting new patients

Locations

3960 Broadway Blvd
Ste 230
Garland, TX 75043
Phone (214) 584-4103

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1720149982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 HORIZON DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431869",
            "telephone_number": "972-303-2800",
            "fax_number": "469-366-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 BROADWAY BLVD STE 230",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750432591",
            "telephone_number": "972-303-2800",
            "fax_number": "469-442-0647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Horizon Dr",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750431869",
            "country_code": "US",
            "telephone_number": "972-303-2800",
            "fax_number": "469-366-1655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NZEADIBE",
        "first_name": "GEOFFREY",
        "middle_name": "IHEUKWUMERE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCKY",
            "last_name": "ENTERPRISE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.