Individual provider Active NPI

Ifeoma Jennifer Ukwamedua, AGNP-C

  • Primary Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1831609528
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP135344 Issued in TX
Practice address
14611 Wynbourn Way
Houston, TX 77083-4700
Phone
(281) 302-9885
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP135344 TX
Gerontology Nurse Practitioner 363LG0600X AP135344 TX
Primary Care Nurse Practitioner 363LP2300X AP135344 TX Primary

Addresses

Primary practice location

14611 Wynbourn Way
Houston, TX 77083-4700

Mailing address

14611 Wynbourn Way
Houston, TX 77083-4700
Phone (281) 302-9885

Other identifiers 1

IdentifierTypeStateIssuer
AP135344OtherTXTEXAS BOARD OF NURSING

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
AP135344TXMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1831609528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14611 WYNBOURN WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770834700",
            "telephone_number": "281-302-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14611 WYNBOURN WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770834700",
            "telephone_number": "281-302-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKWAMEDUA",
        "first_name": "IFEOMA",
        "middle_name": "JENNIFER",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP135344",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP135344",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP135344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP135344",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.