NPIMap

Organization Active NPI

Longview Wellness Center Inc

Doing business as Wellness Pointe

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
National Provider Identifier
1093470221
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LONGVIEW WELLNESS CENTER INC
Doing business as
Wellness Pointe
Practice address
1001 W Fairmont St
Longview, TX 75604-3511
Phone
(903) 758-2610
Fax
(903) 758-7081
NPI assigned
Nov 2, 2021
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LONGVIEW WELLNESS CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Timothy Chad Jones
Title
Ceo
Phone
(903) 758-2610

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Ambulatory Family Planning Facility 261QA0005X NU
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Multi-Specialty Clinic/Center 261QM1300X NU
Primary Care Clinic/Center 261QP2300X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

1001 W Fairmont St
Longview, TX 75604-3511

Mailing address

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other names 1

  • Wellness Pointe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050714001046 TX Part B Supplier - Clinic/Group Practice 1254367766 Receives reassigned benefits from 130 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Longview, TX; Mount Pleasant, TX; Tyler, TX; Gilmer, TX; Kilgore, TX
O20220317000667 TX Part A Provider - Federally Qualified Health Center (FQHC) 1254367766 Practice locations: Longview, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093470221. Details of each certification follow.

Federally qualified health center certification: CCN 451179

Legal name
LONGVIEW WELLNESS CENTER INC
Doing business as
WELLNESS POINTE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 9, 2022
Last certification
Mar 9, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Aug 29, 1997 in TX
Enrollment address
1001 W Fairmont
Longview, TX 75604-3511

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

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
45D2244170Longview Wellness Center Inc1001 W Fairmont, Longview, TX 75604Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Longview Wellness Cente28 organizations share this tax ID, including this one
Part of
Longview Wellness Cente

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

825 Medical Dr
Tyler, TX 75701
Phone (903) 533-0733

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Terrie Mogavero Individual W-2 Managing EmployeeCredentialing Specialist Nov 19, 2012 100%
Longview Wellness Center Inc Organization, Longview, TX Non-profit Operational/Managerial Control Jan 4, 2022 100%
Casey D Robertson Individual Corporate DirectorBoard Member Aug 20, 2015 100%
Gabriela Soliz Individual Corporate DirectorBoard Member Feb 9, 2015 100%
Timothy C Jones Individual Corporate OfficerChief Executive Officer Aug 6, 2013 100%
W-2 Managing EmployeeChief Executive Officer Aug 6, 2013 100%
Operational/Managerial ControlCeo Aug 6, 2013 100%
Ingrid Self Individual Corporate DirectorBoard Member Jan 1, 2022 100%
Mary a Hagenbucher Individual Corporate DirectorBoard Member Aug 21, 2012 100%
Susan B Warford Individual Corporate OfficerChief Financial Officer Jun 16, 2018 100%
W-2 Managing EmployeeChief Financial Officer Jun 16, 2018 100%
Operational/Managerial ControlChief Financial Officer Jun 16, 2018 100%
Kent Phillips Individual Corporate DirectorBoard Member Jun 18, 2019 100%
Tamiko Richardson Individual Corporate OfficerCorporate Compliance Officer Oct 1, 2018 100%
W-2 Managing EmployeeCorporate Compliance Officer Oct 1, 2018 100%
Operational/Managerial ControlCorporate Compliance Officer Oct 1, 2018 100%
Brad Osburg Individual Corporate DirectorBoard Member Jan 1, 2022 100%
Matt Tooker Individual Corporate DirectorBoard Member Jan 15, 2013 100%
Donna Habinc Individual Corporate DirectorBoard Member Jan 16, 2020 100%
Rik Brack Individual Corporate DirectorBoard Member Jul 16, 2018 100%
Valerie Baxter Individual Corporate DirectorBoard Member Jan 1, 2022 100%

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wellness PointeKilgore, TX, CCN 671962 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 6, 2013
Aug 6, 2013
Wellness PointeLongview, TX, CCN 741867 Federally qualified health center Operational/Managerial Control (100%) Aug 6, 2013
Wellness PointeLongview, TX, CCN 741884 Federally qualified health center Operational/Managerial Control (100%) Aug 6, 2013
Wellness PointeLongview, TX, CCN 451113 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 6, 2013
Aug 6, 2013
Wellness PointeTyler, TX, CCN 451151 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 6, 2013
Feb 1, 2021
Longview Wellness Center IncLongview, TX, CCN 671106 Federally qualified health center Operational/Managerial Control (100%) Aug 21, 2023
Wellness PointeLongview, TX, CCN 671198 Federally qualified health center Operational/Managerial Control (100%) Aug 6, 2013
Wellness PointeLongview, TX, CCN 971076 Federally qualified health center Operational/Managerial Control (100%) Apr 11, 2025
Wellness PointeLongview, TX, CCN 971073 Federally qualified health center Operational/Managerial Control (100%) Apr 11, 2025

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 9

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": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1093470221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W FAIRMONT ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756043511",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGVIEW WELLNESS CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONGVIEW WELLNESS CENTER INC",
        "enumeration_date": "2021-11-02",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-758-2610"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Pointe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness Pointe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.