Individual provider Active NPI

Joanna N Ahounou, PMHNP

  • Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1750634002
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
692426 Issued in TX
Practice address
3109 6TH Ave
Suite B
Ft Worth, TX 76110-3800
Phone
(682) 312-7339
NPI assigned
Oct 24, 2012
Last updated
Dec 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 692426 TX Primary

Addresses

Primary practice location

3109 6TH Ave
Suite B
Ft Worth, TX 76110-3800

Mailing address

PO Box 54455
Hurst, TX 76054-4455
Phone (817) 679-0133

Other identifiers 1

IdentifierTypeStateIssuer
315192004MedicaidTX

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
I20130325000405 TX Practitioner - Nurse Practitioner 1850536731 Reassigns benefits to 1 organization
Practice locations: Ft. Worth, TX; Grapevine, TX; Haltom City Texas, TX; Irving, TX; Keene, TX; Keller, TX; Dallas, TX; Kennedale, TX…

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

914 N Locust St
Denton, TX 76201-2954
Phone (817) 298-9402

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
692426TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LTHC Solutions LLC Past Accepting new patients

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": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1750634002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54455",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760544455",
            "telephone_number": "817-679-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 6TH AVE",
            "address_2": "SUITE B",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761103800",
            "telephone_number": "682-312-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHOUNOU",
        "first_name": "JOANNA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "692426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315192004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.