Individual provider Active NPI

Sonya L Wandji, NP

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1730678582
Registry record updated Jul 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136954 Issued in TX
Practice address
929 W Pioneer Pkwy Ste a
Grand Prairie, TX 75051-4726
Phone
(214) 612-6164
Fax
(817) 796-1100
NPI assigned
May 8, 2018
Last updated
Jul 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2020

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 AP136954 TX Primary

Addresses

Primary practice location

929 W Pioneer Pkwy Ste a
Grand Prairie, TX 75051-4726

Mailing address

2512 County Road 529
Burleson, TX 76028-2457
Phone (256) 631-6830

Other practice location 1

2512 County Road 529
Burleson, TX 76028-7602
Phone (817) 666-0193

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
I20200716001498 TX Practitioner - Nurse Practitioner 5294084984

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP136954TXMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1730678582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 COUNTY ROAD 529",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760282457",
            "telephone_number": "256-631-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W PIONEER PKWY STE A",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514726",
            "telephone_number": "214-612-6164",
            "fax_number": "817-796-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2512 County Road 529",
            "address_purpose": "LOCATION",
            "city": "Burleson",
            "state": "TX",
            "postal_code": "760287602",
            "country_code": "US",
            "telephone_number": "817-666-0193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANDJI",
        "first_name": "SONYA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.