Active NPI
Houston Primary Care Physicians, LLC
Doing business as Houston Family Care at Bonaire
- Family Medicine Physician
- Kathleen, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- HOUSTON PRIMARY CARE PHYSICIANS, LLC
- Doing business as
- Houston Family Care at Bonaire
Houston Family Care at Houston Lake - Practice address
- 2510 Ga Highway 127
Kathleen, GA 31047-2828 - Phone
- (478) 352-7143
- Fax
- (478) 352-7144
- NPI assigned
- Apr 8, 2021
- Last updated
- Sep 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sean Steven Whilden
- Title
- VP/Cfo
- Phone
- (478) 542-7959
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2510 Ga Highway 127
Kathleen, GA 31047-2828
Mailing address
2510 Ga Highway 127
Kathleen, GA 31047-2828
Phone (478) 352-7143
Other practice location 1
127 Old Highway 96 Ste B
Bonaire, GA 31005
Phone (478) 352-7143
Other names 2
- Houston Family Care at Bonaire
- Houston Family Care at Houston Lake
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130801000662 | GA | Part B Supplier - Clinic/Group Practice | 4587805684 |
Receives reassigned benefits from 24 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bonaire, GA; Kathleen, GA; Perry, GA; Warner Robins, GA |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Houston Family Care at Perry
- Family Medicine Physician
- Perry, GA
- NPI 1598279200
O20130801000662
-
- Family Medicine Physician
- Warner Robins, GA
- NPI 1619314408
O20130801000662
-
dba Houston Internal Medicine Associates
- Internal Medicine Physician
- Warner Robins, GA
- NPI 1134840309
O20130801000662
-
dba Houston Family Care Associates at The Pavilion
- Family Medicine Physician
- Warner Robins, GA
- NPI 1295298313
O20130801000662
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2231914 | Houston Primary Care Physicians, LLC | Certificate of waiver | Apr 18, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Houston Primary Care
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Houston Family Care at Perry
- Family Medicine Physician
- Perry, GA
- NPI 1598279200
-
- Family Medicine Physician
- Warner Robins, GA
- NPI 1619314408
-
dba Houston Internal Medicine Associates
- Internal Medicine Physician
- Warner Robins, GA
- NPI 1134840309
Locations
127 Old Highway 96
Ste B
Bonaire, GA 31005
Phone (478) 352-7143
2510 GA Highway 127
Kathleen, GA 31047
Phone (478) 352-7143
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Nurse Practitioner
- Bonaire, GA
- NPI 1306293592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693958400000",
"number": "1497335194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 GA HIGHWAY 127",
"city": "KATHLEEN",
"state": "GA",
"postal_code": "310472828",
"telephone_number": "478-352-7143",
"fax_number": "478-352-7144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 GA HIGHWAY 127",
"city": "KATHLEEN",
"state": "GA",
"postal_code": "310472828",
"telephone_number": "478-352-7143",
"fax_number": "478-352-7144"
}
],
"practiceLocations": [
{
"address_1": "127 Old Highway 96 Ste B",
"address_purpose": "LOCATION",
"city": "Bonaire",
"state": "GA",
"postal_code": "31005",
"country_code": "US",
"telephone_number": "478-352-7143",
"fax_number": "478-352-7144",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "HOUSTON PRIMARY CARE PHYSICIANS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-08",
"last_updated": "2023-09-06",
"certification_date": "2023-09-05",
"status": "A",
"authorized_official_last_name": "WHILDEN",
"authorized_official_first_name": "SEAN",
"authorized_official_middle_name": "STEVEN",
"authorized_official_title_or_position": "VP/CFO",
"authorized_official_telephone_number": "478-542-7959"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Houston Family Care at Bonaire",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Houston Family Care at Bonaire",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Houston Family Care at Houston Lake",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kathleen, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.