Organization Active NPI

Concord Healthcare Solutions PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wylie, TX
National Provider Identifier
1235705906
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CONCORD HEALTHCARE SOLUTIONS PLLC
Doing business as
Concord Healthcare Solutions PLLC
Practice address
1825 Virtue Port LN
Wylie, TX 75098-0559
Phone
(469) 463-4638
Fax
(214) 660-8083
NPI assigned
Jun 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Margaret NnandilobiNPI 1588281422
Title
Manager
Phone
(469) 463-4638

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1825 Virtue Port LN
Wylie, TX 75098-0559

Mailing address

1825 Virtue Port LN
Wylie, TX 75098-0559
Phone (469) 463-4638

Other names 1

  • CONCORD HEALTHCARE SOLUTIONS PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210622001867 TX Part B Supplier - Clinic/Group Practice 6406257930 Receives reassigned benefits from 1 practitioner
Practice locations: Wylie, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2229328Concord Healthcare Solutions PLLC1825 Virtue Port LN, Wylie, TX 75098Certificate of waiverJul 9, 2027

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.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1235705906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 VIRTUE PORT LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980559",
            "telephone_number": "469-463-4638",
            "fax_number": "214-660-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 VIRTUE PORT LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980559",
            "telephone_number": "469-463-4638",
            "fax_number": "214-660-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD HEALTHCARE SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "NNANDILOBI",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-463-4638"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONCORD HEALTHCARE SOLUTIONS PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONCORD HEALTHCARE SOLUTIONS PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.