Individual provider Active NPI

Patricia Emefiele, FNP

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1861987737
Registry record updated Jun 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP137702 Issued in TX
Practice address
1202 W Pioneer Dr Ste 100
Irving, TX 75061-7308
Phone
(972) 254-7272
NPI assigned
Jun 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2018

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 AP137702 TX Primary

Addresses

Primary practice location

1202 W Pioneer Dr Ste 100
Irving, TX 75061-7308

Mailing address

343 Alex Dr
Coppell, TX 75019-2942
Phone (214) 205-7648

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190122000329 TX Practitioner - Nurse Practitioner 6507016862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP137702TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsom Clinic PA CurrentSince Nov 23, 2018 Accepting new patients

Locations

1202 W Pioneer Dr
Ste 100
Irving, TX 75061
Phone (972) 254-7272

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529798400000",
    "number": "1861987737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 ALEX DR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192942",
            "telephone_number": "214-205-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W PIONEER DR STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750617308",
            "telephone_number": "972-254-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMEFIELE",
        "first_name": "PATRICIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-24",
        "last_updated": "2018-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.