Individual provider Active NPI

Valerie Jean Cheatham, A/GNP

  • Gerontology Nurse Practitioner
  • Katy, TX
National Provider Identifier
1235195595
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
563679 Issued in TX
Practice address
24275 Katy Fwy Ste 400
Katy, TX 77494-7267
Phone
(346) 387-7171
Fax
(844) 703-5305
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 563679 TX Primary

Addresses

Primary practice location

24275 Katy Fwy Ste 400
Katy, TX 77494-7267

Mailing address

24275 Katy Fwy Ste 400
Katy, TX 77494-7267
Phone (346) 387-7171

Other identifiers 5

IdentifierTypeStateIssuer
500000774OtherTXRAILROAD GBA - RAILROAD MEDICARE
038004002MedicaidTX
80N446OtherTXBCBS
038004001MedicaidTX
P01090515OtherTXRAILROAD MEDICARE PTAN

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
I20100615000326 TX Practitioner - Nurse Practitioner 2769512953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Collaborative Geriatrics IncGroup PAC ID 5193827046, 45 clinicians

Practice addresses (Care Compare)

24285 Katy Fwy
Suite 300
Katy, TX 77494-1327
Phone (346) 387-7171

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Geriatrics Inc Gerontology CurrentSince Apr 1, 2012 Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients

Locations

24275 Katy Fwy
Ste 400
Katy, TX 77494
Phone (346) 387-7171

24285 Katy Fwy
Ste 300
Katy, TX 77494
Phone (346) 387-7171

1405 Valhalla Dr
Wharton, TX 77488
Phone (713) 723-9068

Interoperability endpoints

  • Direct secure messaging: valerie.cheatham.1@12705.direct.athenahealth.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1235195595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "VALERIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "A/GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "563679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GBA - RAILROAD MEDICARE",
            "identifier": "500000774",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038004002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80N446",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038004001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01090515",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.