Organization Active NPI

Core Care Health LLC

  • Gerontology Nurse Practitioner
  • Austin, TX
National Provider Identifier
1235951864
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
CORE CARE HEALTH LLC
Practice address
5900 Balcones Dr # TX
Austin, TX 78731-4257
Phone
(000) 000-0000
Fax
(000) 000-0000
NPI assigned
Oct 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Abiodun Ambali, AGACNP-BC ACUTE CARENPI 1831764703
Title
Owner/Ceo
Phone
(000) 000-0000

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
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X Primary

Addresses

Primary practice location

5900 Balcones Dr # TX
Austin, TX 78731-4257

Mailing address

22947 Banff Brook Way
Tomball, TX 77375-1420
Phone (000) 000-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107000553 TX Part B Supplier - Clinic/Group Practice 0941734412 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

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": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1235951864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22947 BANFF BROOK WAY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773751420",
            "telephone_number": "000-000-0000",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR # TX",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "000-000-0000",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE CARE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "AMBALI",
        "authorized_official_first_name": "ABIODUN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "000-000-0000",
        "authorized_official_credential": "AGACNP-BC ACUTE CARE"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.