Individual provider Active NPI

Chuck C Okeadu Sr., PT

  • Community/Behavioral Health Agency
  • Houston, TX
National Provider Identifier
1386848539
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
82A Issued in TX
Practice address
Special Home Care Living Center
9898 Bissonnet Suite 585
Houston, TX 77036
Phone
(713) 771-3133
Fax
(713) 771-3113
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X
Contractor 171W00000X 82A TX
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X 82A TX
Community/Behavioral Health Agency 251S00000X 82A TX Primary

Addresses

Primary practice location

Special Home Care Living Center
9898 Bissonnet Suite 585
Houston, TX 77036

Mailing address

Special Home Care Living Center
9898 Bissonnet Suite 585
Houston, TX 77036
Phone (713) 771-3133

Other identifiers 4

IdentifierTypeStateIssuer
111894502MedicaidTX
111894503MedicaidTX
82AMedicaidTX
111894501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
82ATXMDCommunity Health Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1386848539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SPECIAL HOME CARE LIVING CENTER",
            "address_2": "9898 BISSONNET SUITE 585",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "713-771-3133",
            "fax_number": "713-771-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPECIAL HOME CARE LIVING CENTER",
            "address_2": "9898 BISSONNET SUITE 585",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "713-771-3133",
            "fax_number": "713-771-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEADU",
        "first_name": "CHUCK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "82A",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "TX",
            "license": "82A",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "82A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111894502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111894503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82A",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111894501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.