Organization Active NPI

Complete Family Wellness PLLC

  • General Practice Physician
  • Carrollton, TX
National Provider Identifier
1083198691
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COMPLETE FAMILY WELLNESS PLLC
Practice address
4125 Fairway Dr Ste 190
Carrollton, TX 75010-6506
Phone
(469) 431-0486
NPI assigned
Sep 19, 2018
Last updated
Jun 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Dr. Salima JafferNPI 1003076167
Title
Director
Phone
(469) 431-0486

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

4125 Fairway Dr Ste 190
Carrollton, TX 75010-6506

Mailing address

4125 Fairway Dr Ste 190
Carrollton, TX 75010-6506
Phone (469) 431-0486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181119002895 TX Part B Supplier - Clinic/Group Practice 9032463575 Receives reassigned benefits from 2 practitioners
Practice locations: Carrollton, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2158653Complete Family Wellness4125 Fairway Dr Suite 190, Carrollton, TX 75010Certificate of waiverDec 3, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1083198691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 FAIRWAY DR STE 190",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106506",
            "telephone_number": "469-431-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 FAIRWAY DR STE 190",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106506",
            "telephone_number": "469-431-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FAMILY WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "JAFFER",
        "authorized_official_first_name": "SALIMA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-431-0486",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.