Deepa Tony Abraham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP133659 Issued in TX

Practice address

609 Hemphill St
Fort Worth, TX 76104-3149

Phone

(817) 923-8484

NPI assigned

Dec 21, 2016

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Deepa Kochethu Former name

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John Allen Van Wagoner, MD, PAGroup PAC ID 9335273390, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• John Allen Van Wagoner, MD, PA

  dba Southwest Allergy and Asthma Center

  • Specialist
  • Plano, TX
  • NPI 1316063993

  Single Specialty

  Medicare reassignment Care Compare group NPD
• VMD Primary Providers North Texas, PLLC

  dba Village Medical

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1295338358

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760927172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 HOLLYHEAD WAY",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997517",
            "telephone_number": "405-371-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 HEMPHILL ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043149",
            "telephone_number": "817-923-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10416 Hollyhead Way",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "730997517",
            "country_code": "US",
            "telephone_number": "405-371-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "DEEPA",
        "middle_name": "TONY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133659",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "95153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEEPA",
            "last_name": "KOCHETHU",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Akhil Abraham, DO
• Albin Abraham
• Arlene Abraham, DO
• Ashley Ann Abraham, DO
• Chigane Abraham
• Jephine Abraham, PHARM D
• Joy Fields Abraham, NURSE PRACTITIONER
• Koshy O Abraham, MD
• Priscilla Abraham, PA-C
• Tina Abraham, PHARMD

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.