Organization Active NPI

Dreamluxxe Medspa & Wellness LLC

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1568096816
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DREAMLUXXE MEDSPA & WELLNESS LLC
Practice address
5103 Magna Carta Blvd Ste 150
Grand Prairie, TX 75052-5234
Phone
(972) 639-3464
Fax
(469) 340-4080
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Chinwem Nwonumah, NURSE PRACTITIONER
Title
Owner
Phone
(972) 639-3464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5103 Magna Carta Blvd Ste 150
Grand Prairie, TX 75052-5234

Mailing address

7205 Wind Elm CT
Arlington, TX 76002-3877
Phone (972) 639-3464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200329000664 TX Part B Supplier - Clinic/Group Practice 5597194449 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Prairie, 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
45D2264432Dreamluxxe Medspa & Wellness5103 Magna Carta Blvd Suite 150, Grand Prairie, TX 75052Certificate of waiverJul 13, 2026

National Provider Directory

National Provider Directory

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": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1568096816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7205 WIND ELM CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760023877",
            "telephone_number": "972-639-3464",
            "fax_number": "817-400-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 MAGNA CARTA BLVD STE 150",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750525234",
            "telephone_number": "972-639-3464",
            "fax_number": "469-340-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMLUXXE MEDSPA & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "NWONUMAH",
        "authorized_official_first_name": "CHINWEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-639-3464",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.