Individual provider Active NPI

Mavis Nwokorie

  • Registered Nurse
  • Dallas, TX
National Provider Identifier
1992328751
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9522025 Issued in CA
Practice address
3544 Fawn Valley Dr Apt 1024
Dallas, TX 75224-5256
Phone
(214) 524-9410
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9522025 CA Primary

Addresses

Primary practice location

3544 Fawn Valley Dr Apt 1024
Dallas, TX 75224-5256

Mailing address

3544 Fawn Valley Dr Apt 1024
Dallas, TX 75224-5256

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

LicenseStateTypeSpecialty
9522025CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1992328751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 FAWN VALLEY DR APT 1024",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752245256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 FAWN VALLEY DR APT 1024",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752245256",
            "telephone_number": "214-524-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOKORIE",
        "first_name": "MAVIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "9522025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.