Individual provider Active NPI

Fidelia Ijeuru Ukah, NURSE PRACTITIONER

  • Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1740211531
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
580397 Issued in TX
Practice address
19900 Hwy. 59
Sugar Land, TX 77479
Phone
(281) 341-8330
Fax
(713) 358-4805
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 580397 TX Primary

Addresses

Primary practice location

19900 Hwy. 59
Sugar Land, TX 77479

Mailing address

12810 Candace CT
Missouri City, TX 77489-3957
Phone (281) 261-0288

Other identifiers 1

IdentifierTypeStateIssuer
8X3689OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000574 TX Practitioner - Nurse Practitioner 3971577578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
580397TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Americas-Long Point PLLC CurrentSince Jan 11, 2022 Accepting new patients
Vanguard Geriatrics Inc Past Accepting new patients
Fred E Griffiths Past Accepting new patients
RCMH, LLC Past Accepting new patients
RCMH, LLC Past Accepting new patients

Locations

8635 Long Point Rd
Ste B
Houston, TX 77055
Phone (713) 973-8292

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1740211531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12810 CANDACE CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774893957",
            "telephone_number": "281-261-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 HWY. 59",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "77479",
            "telephone_number": "281-341-8330",
            "fax_number": "713-358-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKAH",
        "first_name": "FIDELIA",
        "middle_name": "IJEURU",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "580397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X3689",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.