Individual provider Active NPI

Angie Ngozi Ikwuemesi

  • Family Nurse Practitioner
  • Richmond, TX
National Provider Identifier
1982310553
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1087083 Issued in TX
Practice address
10193 W.Grand Pkwy S Ste 103, P.O.Box 102
Richmond, TX 77407
Phone
(281) 309-1597
NPI assigned
Jan 26, 2023
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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 1087083 TX Primary

Addresses

Primary practice location

10193 W.Grand Pkwy S Ste 103, P.O.Box 102
Richmond, TX 77407

Mailing address

10193 W.Grand Pkwy S Ste 103, P.O.Box 102
Richmond, TX 77407
Phone (281) 309-1597

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
I20251002004138 TX Practitioner - Nurse Practitioner 5092252965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1087083TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pallicare, Inc Multi-Specialty CurrentSince Sep 17, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Multi-Specialty CurrentSince Aug 8, 2025 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1982310553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10193 W.GRAND PKWY S STE 103, P.O.BOX 102",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77407",
            "telephone_number": "281-309-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10193 W.GRAND PKWY S STE 103, P.O.BOX 102",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77407",
            "telephone_number": "281-309-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKWUEMESI",
        "first_name": "ANGIE",
        "middle_name": "NGOZI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1087083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.