Individual provider Active NPI

Oghosa W Ebomwonyi

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1871199752
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145915 Issued in TX
Practice address
17567 Imperial Valley Dr
Houston, TX 77060-6102
Phone
(281) 877-0187
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 AP145915 TX Primary

Addresses

Primary practice location

17567 Imperial Valley Dr
Houston, TX 77060-6102

Mailing address

17567 Imperial Valley Dr
Houston, TX 77060-6102
Phone (281) 877-0187

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
I20240424001285 TX Practitioner - Nurse Practitioner 0840630836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Armstrong Medical Group PLLC 30 clinicians

Practice addresses (Care Compare)

1307 W League City Pkwy
League City, TX 77573-6313
Phone (281) 332-2626

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145915TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Clinic, LLC CurrentSince Dec 13, 2020 Accepting new patients
Hourclinic LLC PastSince Dec 13, 2020 Accepting new patients

Locations

17567 Imperial Valley Dr
Houston, TX 77060
Phone (281) 873-2500

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1871199752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17567 IMPERIAL VALLEY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770606102",
            "telephone_number": "281-877-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17567 IMPERIAL VALLEY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770606102",
            "telephone_number": "281-877-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBOMWONYI",
        "first_name": "OGHOSA",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.