Individual provider Active NPI

Iheoma Edoro Anyaegbu

  • Licensed Vocational Nurse
  • Plano, TX
National Provider Identifier
1841781804
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
215917 Issued in TX
Practice address
4701 14TH St Apt 11305
Plano, TX 75074-7321
Phone
(214) 607-5411
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 215917 TX Primary

Addresses

Primary practice location

4701 14TH St Apt 11305
Plano, TX 75074-7321

Mailing address

4701 14TH St Apt 11305
Plano, TX 75074-7321
Phone (214) 607-5411

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
215917TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1841781804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 14TH ST APT 11305",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747321",
            "telephone_number": "214-607-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 14TH ST APT 11305",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747321",
            "telephone_number": "214-607-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYAEGBU",
        "first_name": "IHEOMA",
        "middle_name": "EDORO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "215917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.