NPIMap

Organization Active NPI

Van Health and Wellness, PLLC

  • Clinic/Center
  • Van, TX
National Provider Identifier
1194482778
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
VAN HEALTH AND WELLNESS, PLLC
Practice address
488 W. Main Street
Van, TX 75790
Phone
(903) 963-6850
NPI assigned
Nov 18, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Constance Bentley, ANP-CNPI 1447243571
Title
Owner
Phone
(903) 368-0414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

488 W. Main Street
Van, TX 75790

Mailing address

2299 VZ County Road 4909
Ben Wheeler, TX 75754-4220
Phone (903) 368-0414

Other names 1

  • Van Family Medical Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL CHARM Direct

National Provider Directory

National Provider Directory
Tax ID family
Van Family Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

488 W Main St
Van, TX 75790
Phone (903) 963-6850

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": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1194482778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 VZ COUNTY ROAD 4909",
            "city": "BEN WHEELER",
            "state": "TX",
            "postal_code": "757544220",
            "telephone_number": "903-368-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 W. MAIN STREET",
            "city": "VAN",
            "state": "TX",
            "postal_code": "75790",
            "telephone_number": "903-963-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN HEALTH AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-07",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-368-0414",
        "authorized_official_credential": "ANP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "CHARM",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "488 W. Main Street",
            "city": "Van",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Van Family Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Van, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.