KSJGQ LLC (NPI# 1225689144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225689144 |
| Entity Type | Organization |
| Organization Name | KSJGQ LLC |
| Other Organization Name | KSJGQ |
| Practice Address |
9009 White Rock Trl Dallas TX 75238-3347 |
| Mailing Address |
9607 Walnut St Apt 11104 Dallas TX 75243-2363 |
| Practice Telephone | 2146360418 |
| Mailing Telephone | 2146360418 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | LAWRENCE IDIGBE (NURSE PRACTITIONER) |
| Authorized Official Telephone | 2146360418 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| KSJGQ | Doing Business As Name - Organization |
| Street Address |
9009 WHITE ROCK TRL |
| City | DALLAS |
| State | TX |
| Zip Code | 75238-3347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093704710 | Senior Management Services of Doctors At Dallas Inc | Skilled Nursing Facility | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2005-10-14 |
| 1649824509 | Lawrence Idigbe | Nurse Practitioner | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2019-07-30 |
| 1811479389 | Pearl Collins | Physical Therapy Assistant | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-31 |
| 1245712934 | Gayatri Brown | Speech-Language Pathologist | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-30 |
| 1942782636 | Isheanesu Nyangani | Physical Therapist | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-30 |
| 1174005763 | Emily Hall | Speech-Language Pathologist | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-30 |
| 1669954442 | Roy K Thomas | Physical Therapy Assistant | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-29 |
| 1396227187 | Richard Lim Chi Yan | Occupational Therapy Assistant | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-29 |
| 1265914089 | Elise Fuller | Occupational Therapy Assistant | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-08-29 |
| 1427555366 | Anish G Abraham | Occupational Therapist | 9009 White Rock Trl, Dallas, TX 75238-3347 | 2018-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205317286 | Felicia Youngblood | Physical Therapist | 8615 Lullwater Dri, Dallas, TX 75238 | 2018-08-27 |
| 1942704283 | Zoom Initiative Incorporated | Clinic/Center | 12959 Jupiter Rd., Suite 140, Dallas, TX 75238 | 2018-03-21 |
| 1104345321 | Lee M Fisher | Developmental Therapist | 10333 Mosscrest Dr, Dallas, TX 75238 | 2017-09-19 |
| 1548716848 | Zoom Health Services Inc | Nursing Care | 12959 Jupiter Road Suite 140, Dallas, TX 75238 | 2016-08-28 |
| 1356691489 | Dallas Emergency Physicians | General Acute Care Hospital | 11042 Wallbrook Dr., Dallas, TX 75238 | 2012-09-17 |
| 1285993477 | Legacy Dental of Mesquite Pllc | Dentist | 9208-b E. R.l. Thorton Expressway, #209-b, Dallas, TX 75238 | 2012-05-09 |
| 1316257710 | T-dental,p.c | Dentist | 9625 Plano Road, 100, Dallas, TX 75238 | 2010-10-19 |
| 1427286764 | Sarah Elizabeth Bryant | Dental Hygienist | 10405 East Northwest Highway, Suite #301, Dallas, TX 75238 | 2009-06-25 |
| 1285868448 | Cordial Care Home Health Services Inc | Home Health | 10935 Estate Lane Suite 182, Dallas, TX 75238 | 2009-05-04 |
| 1558514695 | Lisa Camille Simmons | Counselor | 12959 Jupiter Ln, Dallas, TX 75238 | 2008-11-03 |
| Find all providers in zip 75238 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1699376723 | David James Wainwright | Nurse Practitioner | 3838 Rawlins St Apt 212, Dallas, TX 75219-4247 | 2020-11-04 |
| 1528668860 | Nicole Chadwick | Nurse Practitioner | 14332 Montfort Dr Apt 7306, Dallas, TX 75254-1911 | 2020-10-27 |
| 1952901415 | Melissa Green | Nurse Practitioner | 2301 Cedar Springs Rd Ste 405, Dallas, TX 75201-7869 | 2020-10-26 |
| 1194324640 | Busola Stella Amurawaiye | Nurse Practitioner | 14232 Dallas Pkwy Apt 1614, Dallas, TX 75254-2934 | 2020-10-25 |
| 1164020350 | Christina Wilder | Nurse Practitioner | 821 Allen Street Apt 424, Dallas, TX 75204 | 2020-10-11 |
| 1689288276 | Chinyere Ezeh | Nurse Practitioner | 11700 Audelia Rd Apt 2031, Dallas, TX 75243-4731 | 2020-09-01 |
| 1992317341 | Modern Enhancement | Nurse Practitioner | 2777 N Stemmons Fwy Ste 1141, Dallas, TX 75207-2273 | 2020-08-18 |
| 1679183172 | Stacie Teresa Mccally | Nurse Practitioner | 4055 Valley View Lane, Dallas, TX 75022 | 2020-08-09 |
| 1528678083 | Esther Siriba | Nurse Practitioner | 9304 Forest Ln Ste N244, Dallas, TX 75243-6238 | 2020-08-08 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.