Individual provider Active NPI

Tomitamunokuma Isobo Tariah

  • Psychiatric/Mental Health Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1972373280
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1119126 Issued in TX
Practice address
11931 S Highway 6
Sugar Land, TX 77498-5727
Phone
(832) 461-2447
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1119126 TX Primary

Addresses

Primary practice location

11931 S Highway 6
Sugar Land, TX 77498-5727

Mailing address

13106 Brutus Hill LN
Houston, TX 77072-0108

Other identifiers 1

IdentifierTypeStateIssuer
29157646OtherTXTEXAS DEPARTMENT OF PUBLIC SAFETY

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1972373280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13106 BRUTUS HILL LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770720108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11931 S HIGHWAY 6",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774985727",
            "telephone_number": "832-461-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIAH",
        "first_name": "TOMITAMUNOKUMA",
        "middle_name": "ISOBO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1119126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF PUBLIC SAFETY",
            "identifier": "29157646",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.