Active NPI
Pius Olisadebe Okonkwo
- Home Health Clinical Nurse Specialist
- Euless, TX
National Provider Identifier
1962903435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Clinical Nurse Specialist
- License
- 222587
- Practice address
- 11851 Hideout TRL
Euless, TX 76040-1103 - Phone
- (214) 909-1405
- NPI assigned
- Feb 21, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Clinical Nurse Specialist | 364SH0200X | 222587 | TX | Primary |
Addresses
Primary practice location
11851 Hideout TRL
Euless, TX 76040-1103
Mailing address
11851 Hideout TRL
Euless, TX 76040-1103
Phone (214) 909-1405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22716550 | Other | TX | DRIVERS LICENSE |
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 |
|---|---|---|---|
| 222587 | TX | MD | Home Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1962903435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11851 HIDEOUT TRL",
"city": "EULESS",
"state": "TX",
"postal_code": "760401103",
"telephone_number": "214-909-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11851 HIDEOUT TRL",
"city": "EULESS",
"state": "TX",
"postal_code": "760401103",
"telephone_number": "214-909-1405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKONKWO",
"first_name": "PIUS",
"middle_name": "OLISADEBE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-21",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "364SH0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Home Health",
"state": "TX",
"license": "222587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "22716550",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Euless, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.