Wellcare Family Clinic, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WELLCARE FAMILY CLINIC, INC.

Practice address

18110 Midway Rd Ste 136
Dallas, TX 75287-6632

Phone

(214) 613-6009

Fax

(214) 613-6002

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Godling Obi OnyegbunwaNPI 1588299077

Title

Administrator

Phone

(972) 704-5550

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24141/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Godling Obi Onyegbunwa, NP

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1588299077
  Medicare reassignment Care Compare group NPD Authorized official
• Lillian Bose Onyegbunwa, FNP

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1801248745
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1114481561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18110 MIDWAY RD STE 136",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876632",
            "telephone_number": "972-704-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18110 MIDWAY RD STE 136",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876632",
            "telephone_number": "214-613-6009",
            "fax_number": "214-613-6002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Palo Duro Dr",
            "address_purpose": "LOCATION",
            "city": "Fairview",
            "state": "TX",
            "postal_code": "750691286",
            "country_code": "US",
            "telephone_number": "972-704-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLCARE FAMILY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2022-04-11",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "ONYEGBUNWA",
        "authorized_official_first_name": "GODLING",
        "authorized_official_middle_name": "OBI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-704-5550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Eliza Weldon, DNP
• Evan Weldon
• Hung Welker, SLP
• Well Being DME LLC
• Well Simply LLC
• Krystan Weller, DNP, CRNA
• Joan A Wellhauser
• Gabrielle Kristine Welling, SLP
• Emma Joyce Wellington
• Noble Wellington

• Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.