NPIMap

Organization Active NPI

Champi Medical and Wellness Group Corp

  • Clinical Neuropsychologist
  • Anasco, PR
National Provider Identifier
1386046837
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
CHAMPI MEDICAL AND WELLNESS GROUP CORP
Practice address
107 Calle Maria Monagas Local #1
Esq 65 Infanteria Mental Health Division
Anasco, PR 00610
Phone
(787) 229-1223
Fax
(787) 229-1332
NPI assigned
Sep 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Dr. Cosmarie M Cortes-Rivera, M.D.NPI 1295971646
Title
Medical Director
Phone
(787) 229-1223

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X PR Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PR
Adult Mental Health Clinic/Center 261QM0850X PR

Addresses

Primary practice location

107 Calle Maria Monagas Local #1
Esq 65 Infanteria Mental Health Division
Anasco, PR 00610

Mailing address

PO Box 619
Anasco, PR 00610-0619
Phone (787) 229-1223

National Provider Directory

National Provider Directory
Tax ID family
Champi Medical and Wellness Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1386046837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 619",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006100619",
            "telephone_number": "787-229-1223",
            "fax_number": "787-229-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CALLE MARIA MONAGAS LOCAL #1",
            "address_2": "ESQ 65 INFANTERIA MENTAL HEALTH DIVISION",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "00610",
            "telephone_number": "787-229-1223",
            "fax_number": "787-229-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPI MEDICAL AND WELLNESS GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "CORTES-RIVERA",
        "authorized_official_first_name": "COSMARIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-229-1223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "PR",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anasco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.