Individual provider Active NPI

Solange Noumbissie, APRN-FNP

  • Family Nurse Practitioner
  • Texas City, TX
National Provider Identifier
1154188563
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1088617 Issued in TX
Practice address
9850C Emmett F Lowry Expy Ste 103C
Texas City, TX 77591-2122
Phone
(409) 938-2234
NPI assigned
Mar 1, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1088617 TX Primary

Addresses

Primary practice location

9850C Emmett F Lowry Expy Ste 103C
Texas City, TX 77591-2122

Mailing address

1713 Windy Brook LN
League City, TX 77573-3027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523001258 TX Practitioner - Nurse Practitioner 2264874155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Health and WellnessGroup PAC ID 0143215954, 12 clinicians

Practice addresses (Care Compare)

9850 C Emmett F Lowry Expy
Suite C103
Texas City, TX 77591-2122
Phone (409) 938-2234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1088617TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Health & Wellness Single Specialty CurrentSince Apr 8, 2024 Accepting new patients
Coastal Health & Wellness CurrentSince Apr 8, 2024 Accepting new patients
Coastal Health & Wellness Single Specialty Current Accepting new patients

Locations

4700 Broadway St
Ste 100
Galveston, TX 77551
Phone (409) 763-7204

9850 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-2230

9850 Emmett F Lowry Expy
Ste 103C
Texas City, TX 77591
Phone (409) 938-2234

9850 Emmett F Lowry Expy
Ste C103
Texas City, TX 77591
Phone (409) 938-2234

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1154188563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 WINDY BROOK LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850C EMMETT F LOWRY EXPY STE 103C",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912122",
            "telephone_number": "409-938-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUMBISSIE",
        "first_name": "SOLANGE",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1088617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

Verify at the official NPI Registry.