NPIMap

Individual provider Active NPI

Evbu Omoyemwen Enakpene, MD

  • Cardiovascular Disease Physician
  • Midland, TX
National Provider Identifier
1972816189
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R0710 Issued in TX
Practice address
400 Rosalind Redfern Grover Pkwy Ste 240
Midland, TX 79701-5856
Phone
(432) 221-3600
Fax
(432) 221-5170
NPI assigned
Jul 16, 2010
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Cardiovascular Disease Physician 207RC0000X R0710 TX Primary

Addresses

Primary practice location

400 Rosalind Redfern Grover Pkwy Ste 240
Midland, TX 79701-5856

Mailing address

400 Rosalind Redfern Grover Pkwy Ste 240
Midland, TX 79701-5856
Phone (432) 221-3600

Other identifiers 2

IdentifierTypeStateIssuer
1972816189OtherTXNPI
R0710OtherTXSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address evbu.enakpene.1@9925.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170908002119 TX Practitioner - Cardiovascular Disease (Cardiology) 8325347412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permian Cardiology, Inc.Group PAC ID 2163601303, 8 clinicians

Practice addresses (Care Compare)

400 Rosalind Redfern Grover Pkwy
Suite 240
Midland, TX 79701-5856
Phone (432) 688-0102

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting26
Pacemaker insertion or repair16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Permian Cardiology, Inc. Cardiovascular Disease CurrentSince Sep 1, 2017 Accepting new patients
Permian Cardiology Associates Cardiovascular Disease Current Accepting new patients
Midland Memorial Outpatient Pharmacy Past Accepting new patients

Locations

400 Rosalind Redfern Grover Pkwy
Ste 240
Midland, TX 79701
Phone (432) 221-3600

Interoperability endpoints

  • Direct secure messaging: evbu.enakpene.1@3522.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1972816189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ROSALIND REDFERN GROVER PKWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015856",
            "telephone_number": "432-221-3600",
            "fax_number": "432-221-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROSALIND REDFERN GROVER PKWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015856",
            "telephone_number": "432-221-3600",
            "fax_number": "432-221-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENAKPENE",
        "first_name": "EVBU",
        "middle_name": "OMOYEMWEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "R0710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972816189",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R0710",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evbu.enakpene.1@9925.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Rosalind Redfern Grover Pkwy Ste 240",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797015856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.