Individual provider Active NPI

Chanida Gnayong Tauthong, FNP-BC

  • Family Nurse Practitioner
  • Mission, TX
National Provider Identifier
1003857640
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
600220 Issued in TX
Practice address
2013 E Griffin Pkwy
Mission, TX 78572-3222
Phone
(956) 585-4704
Fax
(956) 585-6775
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 600220 TX Primary

Addresses

Primary practice location

2013 E Griffin Pkwy
Mission, TX 78572-3222

Mailing address

2013 E Griffin Pkwy
Mission, TX 78572-3222
Phone (956) 585-4704

Other identifiers 1

IdentifierTypeStateIssuer
1711194MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000541 TX Practitioner - Nurse Practitioner 6608830385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. CurrentSince Nov 26, 2018 Accepting new patients
Wellmed Medical Group, PA Current Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Nov 26, 2018 Accepting new patients
Rio Grande NP, Inc. Past Accepting new patients

Locations

2013 E Griffin Pkwy
Mission, TX 78572
Phone (956) 585-4704

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: chanida.tauthong@wellmed.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1003857640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 E GRIFFIN PKWY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723222",
            "telephone_number": "956-585-4704",
            "fax_number": "956-585-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 E GRIFFIN PKWY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723222",
            "telephone_number": "956-585-4704",
            "fax_number": "956-585-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUTHONG",
        "first_name": "CHANIDA",
        "middle_name": "GNAYONG",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "600220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1711194",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.