Active NPI
Ademewo Agbebiyi
- Family Nurse Practitioner
- Fresno, TX
National Provider Identifier
1871136705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F07190024
- Practice address
- 1819 Bravos Manor LN
Fresno, TX 77545-1467 - Phone
- (713) 820-1678
- NPI assigned
- Oct 23, 2019
- Last updated
- Oct 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F07190024 | TX | Primary |
Addresses
Primary practice location
1819 Bravos Manor LN
Fresno, TX 77545-1467
Mailing address
1819 Bravos Manor LN
Fresno, TX 77545-1467
Phone (713) 820-1678
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
| License | State | Type | Specialty |
|---|---|---|---|
| F07190024 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1871136705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 BRAVOS MANOR LN",
"city": "FRESNO",
"state": "TX",
"postal_code": "775451467",
"telephone_number": "713-820-1678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 BRAVOS MANOR LN",
"city": "FRESNO",
"state": "TX",
"postal_code": "775451467",
"telephone_number": "713-820-1678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGBEBIYI",
"first_name": "ADEMEWO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-23",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "F07190024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.