Mary Alice Powell

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

111882 Issued in TX

Practice address

8700 Crownhill Blvd Ste 300
San Antonio, TX 78209-1128

Phone

(210) 824-5530

Fax

(210) 824-5323

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Adaptive Health Services, LLC

  • Home Health Agency
  • San Antonio, TX
  • NPI 1831351261
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1265035083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 CROWNHILL BLVD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78209",
            "telephone_number": "210-824-5530",
            "fax_number": "210-824-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 CROWNHILL BLVD STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091128",
            "telephone_number": "210-824-5530",
            "fax_number": "210-824-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "111882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LVN-BOARD OF NURSES",
            "identifier": "111882",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendal Lynn Powell, MD
• Kimberly Ann Powell, RN
• Lauren Christine Powell, D.O.
• Leslie Denise Powell, M.D.
• Mackenzie Lynn Powell
• Sarah Gabriela Powell, BCBA, LBA
• Shanique Powell, FNP-BC
• Taelan Powell
• William Cameron Powell, M.D.
• Power & Resiliency Therapy LLC

• Licensed Vocational Nurse in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.