Individual provider Active NPI

Kadjatou Niangadou, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1932885498
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1069127 Issued in TX
Practice address
910 Carthage Way
Arlington, TX 76017-6551
Phone
(817) 353-0320
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X 61444116 WA
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 1069127 TX Primary

Addresses

Primary practice location

910 Carthage Way
Arlington, TX 76017-6551

Mailing address

910 Carthage Way
Arlington, TX 76017-6551
Phone (817) 353-0320

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
I20250319003948 TX Practitioner - Nurse Practitioner 4880116714 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61444116WAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Primary Care in Texas LLC Multi-Specialty CurrentSince Feb 3, 2025 Accepting new patients
Raguel LLC Multi-Specialty CurrentSince Sep 9, 2025 Accepting new patients

Locations

7311 S Hulen St
Fort Worth, TX 76133
Phone (817) 346-1925

Organizations & group practices 2

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1932885498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 CARTHAGE WAY",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760176551",
            "telephone_number": "817-353-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 CARTHAGE WAY",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760176551",
            "telephone_number": "817-353-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIANGADOU",
        "first_name": "KADJATOU",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61444116",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1069127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.