Individual provider Active NPI

Oluwakemi Bassey Iwanefun, WHNP

  • Women's Health Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1730643347
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP135972 Issued in TX
Practice address
112 Maverick CT., Granbury, TX 76049-1381
Granbury, TX 76049-1381
Phone
(888) 731-8994
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP135972 TX Primary

Addresses

Primary practice location

112 Maverick CT., Granbury, TX 76049-1381
Granbury, TX 76049-1381

Mailing address

112 Maverick CT
Granbury, TX 76049-1381
Phone (888) 731-8994

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.joinmidi.com/ Direct

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
I20220301000385 TX Practitioner - Nurse Practitioner 1355673146 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 3, 2022 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Jan 3, 2022 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3600 Gaston Ave
Ste 1158
Dallas, TX 75246
Phone (214) 820-8585

2460 N Interstate Highway 35 E
Ste 165
Waxahachie, TX 75165
Phone (972) 905-3778

Interoperability endpoints

  • Direct secure messaging: oluwakemi.iwanefun.1@27069.direct.athenahealth.com
  • Direct secure messaging: oiwanefun93441@direct.phhs.org

Organizations & group practices 4

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": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1730643347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MAVERICK CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760491381",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAVERICK CT., GRANBURY, TX 76049-1381",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760491381",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANEFUN",
        "first_name": "OLUWAKEMI",
        "middle_name": "BASSEY",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2025-05-02",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "AP135972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.joinmidi.com/",
            "affiliation": "N",
            "endpointDescription": "Midi Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "112 Maverick Ct., Granbury, TX 76049-1381",
            "city": "Granbury",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760491381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.