Individual provider Active NPI

Callistus Ohaegbu

  • Medical-Surgical Registered Nurse
  • Lakeway, TX
National Provider Identifier
1851254874
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
975334 Issued in TX
Practice address
100 Medical Pkwy
Lakeway, TX 78738-5621
Phone
(512) 654-5000
NPI assigned
Dec 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 975334 TX Primary

Addresses

Primary practice location

100 Medical Pkwy
Lakeway, TX 78738-5621

Mailing address

6715 W Gate Blvd Unit a
Austin, TX 78745-4810
Phone (614) 687-6973

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
975334TXMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1851254874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 W GATE BLVD UNIT A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787454810",
            "telephone_number": "614-687-6973",
            "fax_number": "614-687-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PKWY",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787385621",
            "telephone_number": "512-654-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHAEGBU",
        "first_name": "CALLISTUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-05",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "975334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.