Organization Active NPI

Serenity Healthcare, LLC

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1407526288
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SERENITY HEALTHCARE, LLC
Practice address
2646 S Loop W Ste 423
Houston, TX 77054-2678
Phone
(713) 234-7850
Fax
(713) 234-7844
NPI assigned
Sep 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Shanekwah Melville, FNP-CNPI 1093167215
Title
NP/Owner
Phone
(727) 272-3265

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: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2646 S Loop W Ste 423
Houston, TX 77054-2678

Mailing address

2646 S Loop W Ste 423
Houston, TX 77054-2678
Phone (713) 234-7850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211026002569 TX Part B Supplier - Clinic/Group Practice 6406244318 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2252541Serenity Healthcare LLC2646 South Loop West Suite 423, Houston, TX 77054Certificate of waiverFeb 11, 2028

National Provider Directory

National Provider Directory

Locations

2646 S Loop W
Ste 423
Houston, TX 77054
Phone (713) 234-7850

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": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1407526288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 S LOOP W STE 423",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542678",
            "telephone_number": "713-234-7850",
            "fax_number": "713-234-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 S LOOP W STE 423",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542678",
            "telephone_number": "713-234-7850",
            "fax_number": "713-234-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "MELVILLE",
        "authorized_official_first_name": "SHANEKWAH",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "727-272-3265",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.