Organization Active NPI

Gericare Inc.

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1407070949
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GERICARE INC.
Practice address
2317 Starlight CT
Arlington, TX 76016-6425
Phone
(817) 704-9882
Fax
(817) 704-3269
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Mrs. Kumud K Chawla, FNPNPI 1447301882
Title
President
Phone
(817) 704-9882

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2317 Starlight CT
Arlington, TX 76016-6425

Mailing address

2317 Starlight CT
Arlington, TX 76016-6425
Phone (817) 704-9882

Other identifiers 3

IdentifierTypeStateIssuer
00X981OtherTXMEDICARE PTAN
P00413519OtherTXMEDICARE RAILROAD
149175503MedicaidTX

Other names 1

  • Gericare Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070830000779 TX Part B Supplier - Clinic/Group Practice 9537252986 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Locations

824 W Mayfield Rd
Arlington, TX 76015
Phone (817) 465-2222

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1407070949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 STARLIGHT CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760166425",
            "telephone_number": "817-704-9882",
            "fax_number": "817-277-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 STARLIGHT CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760166425",
            "telephone_number": "817-704-9882",
            "fax_number": "817-704-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERICARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "CHAWLA",
        "authorized_official_first_name": "KUMUD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-704-9882",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00X981",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00413519",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149175503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gericare Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.