Organization Active NPI

Innate Ability LLC

  • Primary Care Clinic/Center
  • Canyon Lake, TX
National Provider Identifier
1033466719
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
11974 Issued in TX
Legal business name
INNATE ABILITY LLC
Practice address
1742 FM 2673
Canyon Lake, TX 78133-4743
Phone
(830) 964-3032
Fax
(830) 964-4460
NPI assigned
Aug 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Authorized official

Name
Dr. Jeffrey Q Harper, DCNPI 1649543455
Title
Owner
Phone
(830) 964-3032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 11974 TX Primary

Addresses

Primary practice location

1742 FM 2673
Canyon Lake, TX 78133-4743

Mailing address

1742 FM 2673
Canyon Lake, TX 78133-4743
Phone (830) 964-3032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120710000141 TX Part B Supplier - Clinic/Group Practice 2668637000 Receives reassigned benefits from 1 practitioner
Practice locations: Canyon Lake, TX

National Provider Directory

National Provider Directory

Locations

1742 FM 2673
Canyon Lake, TX 78133
Phone (830) 964-3032

1742 FM 2673
Ste 1
Canyon Lake, TX 78133
Phone (830) 964-3032

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1033466719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 FM 2673",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334743",
            "telephone_number": "830-964-3032",
            "fax_number": "830-964-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 FM 2673",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334743",
            "telephone_number": "830-964-3032",
            "fax_number": "830-964-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNATE ABILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-964-3032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "11974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Lake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.