Advance Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

ADVANCE FAMILY CLINIC LLC

Practice address

5015 Lark Creek CT
Sugar Land, TX 77479-3866

Phone

(832) 616-6718

NPI assigned

Sep 28, 2021

Organization subpart

No

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

Authorized official

Name

Ezinne Blessing Chukwuocha, NURSE PRACTITIONERNPI 1477046654

Title

FNP

Phone

(832) 616-6718

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ezinne Blessing Chukwuocha, NP

  • Family Nurse Practitioner
  • Sugar Land, TX
  • NPI 1477046654
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1235801366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 LARK CREEK CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793866",
            "telephone_number": "832-616-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 LARK CREEK CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793866",
            "telephone_number": "832-616-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "CHUKWUOCHA",
        "authorized_official_first_name": "EZINNE",
        "authorized_official_middle_name": "BLESSING",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "832-616-6718",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.