Individual provider Active NPI

Charles Udo Enyinna-Okeigbo, RN

  • Home Health Registered Nurse
  • Dallas, TX
National Provider Identifier
1740506724
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
716453 Issued in TX
Practice address
9304 Forest LN
Ste 216 S
Dallas, TX 75243-6238
Phone
(214) 295-4324
Fax
(214) 295-4397
NPI assigned
Apr 15, 2010
Last updated
Apr 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 716453 TX
Home Health Aide 374U00000X 716543 TX
Registered Nurse 163W00000X 716453 TX
Community Health Registered Nurse 163WC1500X 716543 TX
Home Health Registered Nurse 163WH0200X 716453 TX Primary

Addresses

Primary practice location

9304 Forest LN
Ste 216 S
Dallas, TX 75243-6238

Mailing address

9304 Forest LN
Ste 216 S
Dallas, TX 75243-6238
Phone (214) 295-4324

Other names 1

  • Udo Charles Enyinna 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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
716453TXMDRegistered Nurse
716543TXMDHome Health Aide

Organizations & group practices 1

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1740506724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 FOREST LN",
            "address_2": "STE 216 S",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436238",
            "telephone_number": "214-295-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9304 FOREST LN",
            "address_2": "STE 216 S",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436238",
            "telephone_number": "214-295-4324",
            "fax_number": "214-295-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENYINNA-OKEIGBO",
        "first_name": "CHARLES",
        "middle_name": "UDO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "TX",
            "license": "716453",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "TX",
            "license": "716543",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "716453",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "716543",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "716453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "UDO",
            "last_name": "ENYINNA",
            "middle_name": "CHARLES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.