Organization Active NPI

Nexphase Healthcare

  • Family Medicine Physician
  • Mansfield, TX
National Provider Identifier
1083220024
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEXPHASE HEALTHCARE
Practice address
2401 Callender Rd Ste 109
Mansfield, TX 76063-8869
Phone
(817) 500-7577
Fax
(817) 617-2379
NPI assigned
Sep 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Loveline N Nche
Title
Owner
Phone
(817) 500-7577

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Addresses

Primary practice location

2401 Callender Rd Ste 109
Mansfield, TX 76063-8869

Mailing address

2401 Callender Rd Ste 109
Mansfield, TX 76063-8869
Phone (817) 500-7577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200929000721 TX Part B Supplier - Clinic/Group Practice 3173942992 Receives reassigned benefits from 6 practitioners
Practice locations: Mansfield, 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
45D2237309Nexphase Healthcare, LLC2401 Callender Rd Suite 109, Mansfield, TX 76063Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1083220024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 CALLENDER RD STE 109",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638869",
            "telephone_number": "817-500-7577",
            "fax_number": "817-617-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CALLENDER RD STE 109",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638869",
            "telephone_number": "817-500-7577",
            "fax_number": "817-617-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXPHASE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "NCHE",
        "authorized_official_first_name": "LOVELINE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-500-7577"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.