EDOGHOGHO STACY EDOSONMWAN (RN) – Registered Nurse, NPI 1356808901
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,209 NURSE PRACTITIONER in TX
Provider Addresses for EDOGHOGHO STACY EDOSONMWAN (RN)
1001 UTA BLVD APT 408B
ARLINGTON, TX 760136937
Phone: (469) 442-9930
Type: Mailing
1428 E ARLINGTON AVE
FORT WORTH, TX 761046124
Phone:
Type: Mailing
1350 N WESTMORELAND RD
DALLAS, TX 752111654
Phone: (214) 330-0036
Type: Location
3230 REMOND DR.
DALLAS, TX 75211
Phone: (214) 743-1200
Type: Location
201 Amanda Ln Ste 100
Waxahachie, TX 751651391
Phone: (469) 523-2646
Fax: (469) 242-9599
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 34 Open Payments records for all available years, with a total value of $767.
Total Amount is formed as General ($767) + Research ($0) + Ownership ($0) = $767.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: ABBVIE INC. ($271).
Total Amount
$767
General + Research + Ownership
Payments
34
Total payment records
General Amount
$767
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240611001982 | I | Nurse Practitioner | LA | TBD |
| I20240807002562 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76013)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.