MR. FESTUS C OBONNA – Psychiatric/Mental Health Nurse Practitioner, NPI 1417457185
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for MR. FESTUS C OBONNA
1608 Shady Grove Ct
Wylie, TX 750988144
Phone: (865) 696-9226
Type: Location
1608, Shady Grove Court, Wylie, Collin County, Texas, 75098, United States
WYLIE, TX 750988144
Phone: (865) 696-9226
Type: Mailing
John Hickman Parkway, Frisco, Collin County, Texas, 75024:75057, United States
FRISCO, TX 750355894
Phone: (865) 696-9226
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-03-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
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 |
|---|---|---|---|---|
| I20210223000365 | I | Nurse Practitioner | TX | TBD |
| I20260212000864 | I | Nurse Practitioner | NY | TBD |
| I20260212003604 | I | Nurse Practitioner | IA | TBD |
| I20260216000366 | I | Nurse Practitioner | CO | TBD |
| I20260216000444 | I | Nurse Practitioner | NM | TBD |
| I20260221000285 | I | Nurse Practitioner | AZ | TBD |
| I20260304001592 | I | Nurse Practitioner | CA | 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 75098)
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