FARIDY MAYA MOMBELEUR (NPI# 1245790914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245790914 |
Entity Type | Individual |
Full Name | FARIDY MAYA MOMBELEUR |
Practice Address |
2000 S Fm 51 Ste C Decatur TX 76234-3702 |
Mailing Address |
1816 S Fm 51 Ste 400 Decatur TX 76234-3788 |
Practice Telephone | 9406261848 |
Practice Fax Number | 9406261849 |
Mailing Telephone | 9406261848 |
Mailing Fax Number | 9406261849 |
Enumeration Date | 2019-03-20 |
Last Update Date | 2019-08-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP140998 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BCBSTX | PENDING | 01 |
TX | PENDING | 05 |
Street Address |
2000 S FM 51 STE C |
City | DECATUR |
State | TX |
Zip Code | 76234-3702 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
Find all providers in zip 76234 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851934988 | Tara Michelle Ridgeway | Nurse Practitioner | 2132 E Decatur St, Decatur, IL 62521-3148 | 2019-10-22 |
1891204152 | Jasmine Keamber Mckinley | Nurse Practitioner | 1615 Kathy Ln Sw Ste 102, Decatur, AL 35603-1026 | 2017-09-29 |
1700305372 | Jessica Skarda | Nurse Practitioner | 1577-1631 Kathy Ln Sw, Decatur, AL 35603 | 2017-09-14 |
1306477138 | Obiageri Ohayagha | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2020-01-30 |
1407405905 | Erica Y Taylor | Nurse Practitioner | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2019-09-06 |
1205309267 | Ashley M Garner | Nurse Practitioner | 320 E Central Ave, Decatur, IL 62521-4665 | 2019-01-02 |
1801379516 | Lauren Colegrove | Nurse Practitioner | 465 Winn Way Ste 221, Decatur, GA 30030-1723 | 2018-09-09 |
1619459542 | Okechukwu Nnaji | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2018-09-06 |
1235634635 | Olubukola Funmi Olatoto | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030 | 2018-03-27 |
1831693357 | Bamidele Odede | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030 | 2018-03-20 |
Find all providers in DECATUR |
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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.