Individual provider Active NPI

Atemnkeng Fonkem Dibaki, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Hill, TX
National Provider Identifier
1750758512
Registry record updated Feb 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP132256 Issued in TX
Practice address
318 W Belt Line Rd Ste 304
Cedar Hill, TX 75104-1103
Phone
(972) 972-4767
Fax
(972) 972-4737
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP132256 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP132256 TX Primary

Addresses

Primary practice location

318 W Belt Line Rd Ste 304
Cedar Hill, TX 75104-1103

Mailing address

318 W Belt Line Rd
Cedar Hill, TX 75104-1104
Phone (972) 972-4767

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
I20170203001555 TX Practitioner - Nurse Practitioner 3476836123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

318 W Belt Line Rd
Suite 304
Cedar Hill, TX 75104-1103
Phone (972) 972-4767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132256TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leanonme Group LLC Psychiatric/Mental Health CurrentSince May 1, 2019 Accepting new patients
Hawkins Psychiatry PC CurrentSince Jul 7, 2017 Accepting new patients
Hope Starts Here LLC PastSince Nov 12, 2023 Accepting new patients

Locations

3614 S Cooper St
Ste 120
Arlington, TX 76015

2233 Avenue J
Ste 101
Arlington, TX 76006
Phone (817) 385-0088

318 W Belt Line Rd
Ste 304
Cedar Hill, TX 75104
Phone (972) 972-4767

2026 W University Dr
Denton, TX 76201
Phone (903) 783-0846

6017 Reef Point Ln
Ste 135
Fort Worth, TX 76135
Phone (682) 706-3019

503 W Harwood Rd
Hurst, TX 76054
Phone (817) 268-4404

Organizations & group practices 3

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675468800000",
    "number": "1750758512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 W BELT LINE RD",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751041104",
            "telephone_number": "972-972-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 W BELT LINE RD STE 304",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751041103",
            "telephone_number": "972-972-4767",
            "fax_number": "972-972-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBAKI",
        "first_name": "ATEMNKENG",
        "middle_name": "FONKEM",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2023-02-04",
        "certification_date": "2023-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP132256",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.