Individual provider Active NPI

Yetunde Adegbamigbe, FNP

  • Family Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1770198830
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142863 Issued in TX
Practice address
16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone
(210) 570-6123
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142863 TX Primary

Addresses

Primary practice location

16655 Southwest Fwy
Sugar Land, TX 77479-2329

Mailing address

16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone (210) 570-6123

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL SugarLand Direct
CONNECT URL SugarLand Direct

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

State licenses

LicenseStateTypeSpecialty
AP142863TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1770198830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16655 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792329",
            "telephone_number": "210-570-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16655 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792329",
            "telephone_number": "210-570-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGBAMIGBE",
        "first_name": "YETUNDE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SugarLand",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Sugar Land",
            "address_1": "16655 Southwest Fwy",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774792329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SugarLand",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16655 Southwest Fwy",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774792329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.