Organization Active NPI

Anbap Wellness LLC

Doing business as Optimum Medical Family Practice

  • Family Health Clinical Nurse Specialist
  • Nederland, TX
National Provider Identifier
1174913016
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
758246 Issued in TX
Legal business name
ANBAP WELLNESS LLC
Doing business as
Optimum Medical Family Practice
Practice address
1003 Nederland Ave
Nederland, TX 77627
Phone
(409) 221-8294
Fax
(409) 344-9592
NPI assigned
Jan 30, 2015
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Kevin G Morgan, FNPNPI 1518399393
Title
Owner
Phone
(409) 221-8294

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 758246 TX Primary

Addresses

Primary practice location

1003 Nederland Ave
Nederland, TX 77627

Mailing address

1003 Nederland Ave
Nederland, TX 77627
Phone (409) 221-8294

Other names 1

  • Optimum Medical Family Practice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1174913016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 NEDERLAND AVE",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "77627",
            "telephone_number": "409-221-8294",
            "fax_number": "409-344-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 NEDERLAND AVE",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "77627",
            "telephone_number": "409-221-8294",
            "fax_number": "409-344-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANBAP WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-221-8294",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "TX",
            "license": "758246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Medical Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.