Elite Wellness Clinic PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

ELITE WELLNESS CLINIC PLLC

Practice address

104 Lion St Ste C
Desoto, TX 75115-5071

Phone

(972) 217-0881

NPI assigned

Sep 13, 2024

Organization subpart

No

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

Authorized official

Name

Folake-Tolani Catherine IheanachoNPI 1538873385

Title

Owner

Phone

(972) 217-0881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Folake-Tolani Catherine Iheanacho, FNP-BC

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1538873385
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1508692625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LION ST STE C",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751155071",
            "telephone_number": "972-217-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LION ST STE C",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751155071",
            "telephone_number": "972-217-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "IHEANACHO",
        "authorized_official_first_name": "FOLAKE-TOLANI",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-217-0881"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Desoto, TX
• Providers in Desoto, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.