SIMEON NGISHU


Address: 1900 Mistletoe Blvd Ste 100, Fort Worth, TX 76104-4048
Phone: 8173381300

SIMEON NGISHU (NPI# 1629540497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629540497
Entity Type Individual
Full Name SIMEON NGISHU
Credential NP
Practice Address 1900 Mistletoe Blvd Ste 100
Fort Worth
TX 76104-4048
Practice Telephone 8173381300
Practice Fax Number 8173359871
Mailing Telephone 8173381300
Mailing Fax Number 8173359871
Enumeration Date 2018-12-18
Last Update Date 2019-03-22
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP139942 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 394063701 05

Office Location

Street Address 1900 MISTLETOE BLVD STE 100
City FORT WORTH
State TX
Zip Code 76104-4048

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720039480 Syed Nayyar Shah Internal Medicine 1900 Mistletoe Blvd Ste 100, Fort Worth, TX 76104-4048 2006-05-15
1821342296 Rebecca Jane Lassetter Nurse Practitioner 1900 Mistletoe Blvd Ste 100, Fort Worth, TX 76104-4048 2012-11-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669082186 Cvs Pharmacy, Inc. Durable Medical Equipment & Medical Supplies 1115 8th St, Fort Worth, TX 76104 2020-08-10
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1881189132 Mega Surgical Assistants LLC Specialist/Technologist, Other 1301pennsylvania, Fort Worth, TX 76104 2018-06-28
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1952820979 Modern Vein Clinic Internal Medicine 757 8th Avenue, Suite A, Forth Worth, TX 76104 2017-09-11
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1922537562 Nicole Marie Tod Student in an Organized Health Care Education/Training Program 1500 S Main Street, Fort Worth, TX 76104 2017-06-07
1770025934 Micah Bonola Chiropractor 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 2016-11-04
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215945522 Oddeth Root Nurse Practitioner 431 Fulton St, Fort Worth, TX 76104-2214 2006-08-03
1124537212 Patricia Magness Nurse Practitioner 1500 S Main St, Fort Worth, TX 76104-4917 2017-09-21
1669928891 Ashley Hopkins Nurse Practitioner 2500 Circle Dr, Fort Worth, TX 76119-8138 2016-08-28
1750758512 Atemnkeng Fonkem Dibaki Nurse Practitioner 6017 Reef Point Ln Ste 135, Fort Worth, TX 76135-7006 2015-08-27
1316010507 Penny Marie Brookover Nurse Practitioner 6100 Harris Pkwy, Suite 250, Fort Worth, TX 76132-4101 2006-11-16
1598856551 Ambassador Physician Group LLC Nurse Practitioner 6100 Harris Pkwy, Suite 250, Fort Worth, TX 76132-4101 2006-09-27
1174569735 Virginia L Miloud Nurse Practitioner 1301 W 7th St, Suite 121, Fort Worth, TX 76102-2651 2006-06-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588262570 Holly Joyce Carlstrand Nurse Practitioner 18 Carmel Chase Ct, Manvel, TX 77578-3452 2020-10-13
1700483690 Amy Calder Nurse Practitioner 14441 Memorial Dr Ste 5, Houston, TX 77079-6708 2020-10-05
1104423300 Donna Ann Ford Nurse Practitioner 1605 Turtle Dr, San Angelo, TX 76904-7708 2020-10-01
1497361653 Alexis Jolivet Nurse Practitioner 8706 Shiloh St, Texas City, TX 77591-2327 2020-09-22
1851906960 Ann Nnenna Ugbeme Nurse Practitioner 1601 Lisburn Dr, Mckinney, TX 75071-3357 2020-09-15
1528673233 Lashika R Meanus Nurse Practitioner 10501 Matador Dr, Mckinney, TX 75072-2952 2020-09-10
1700498391 Raphael Udalor Nurse Practitioner 3631 Campfield Ct, Katy, TX 77449-8621 2020-08-17
1326664020 Tasha Samantha Leonard Nurse Practitioner 622 Orlandis Ln, Rosenberg, TX 77469-5084 2020-06-19
1962025171 Shewana Spencer Nurse Practitioner 613 W Bluff St, Woodville, TX 75979-5125 2020-05-21
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Competitor

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City FORT WORTH
Zip Code 76104

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Dataset Information

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.

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