Organization Active NPI

Align Health PLLC

  • Family Medicine Physician
  • Grapevine, TX
National Provider Identifier
1316489156
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALIGN HEALTH PLLC
Practice address
1025 S Main St Ste 305
Grapevine, TX 76051-7506
Phone
(817) 251-0550
Fax
(817) 251-0599
NPI assigned
Nov 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Jerrylee Otimeye Ejuwa, DCNPI 1295007326
Title
Owner
Phone
(817) 251-0550

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 Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

1025 S Main St Ste 305
Grapevine, TX 76051-7506

Mailing address

1025 S Main St Ste 305
Grapevine, TX 76051-7506
Phone (817) 251-0550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170309000145 TX Part B Supplier - Clinic/Group Practice 6103100250 Receives reassigned benefits from 4 practitioners
Practice locations: Grapevine, TX

National Provider Directory

National Provider Directory

Locations

1025 S Main St
Ste 305
Grapevine, TX 76051
Phone (817) 251-0550

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1316489156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S MAIN ST STE 305",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517506",
            "telephone_number": "817-251-0550",
            "fax_number": "817-251-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S MAIN ST STE 305",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517506",
            "telephone_number": "817-251-0550",
            "fax_number": "817-251-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIGN HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "EJUWA",
        "authorized_official_first_name": "JERRYLEE",
        "authorized_official_middle_name": "OTIMEYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-251-0550",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.