Individual provider Active NPI

Mica Chapman, APN

  • Women's Health Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1164594388
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
651592 Issued in TX
Practice address
201 Enterprise Row
Suite 12
Conroe, TX 77301-4448
Phone
(936) 760-2784
Fax
(936) 760-1950
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 651592 TX Primary

Addresses

Primary practice location

201 Enterprise Row
Suite 12
Conroe, TX 77301-4448

Mailing address

7183 Edgewater Dr
Willis, TX 77318-9186
Phone (936) 760-2784

Other identifiers 1

IdentifierTypeStateIssuer
150652902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
651592TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Wellness Clinic, LLP Past Accepting new patients
Community Wellness Clinic, LLP Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIFBAA/Endpoint/FIFBAA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1164594388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7183 EDGEWATER DR",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773189186",
            "telephone_number": "936-760-2784",
            "fax_number": "936-760-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ENTERPRISE ROW",
            "address_2": "SUITE 12",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773014448",
            "telephone_number": "936-760-2784",
            "fax_number": "936-760-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "MICA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "651592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150652902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.