Individual provider Active NPI

Michelle Denise Champion

  • Child Physical Disabilities Respite Care
  • Magnolia, TX
National Provider Identifier
1629433685
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Physical Disabilities Respite CareTaxonomy code 385HR2065X
Practice address
41206 N Mill Dr
Magnolia, TX 77354-1874
Phone
(936) 273-3226
Fax
(936) 273-3226
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Physical Disabilities Respite Care 385HR2065X TX Primary

Addresses

Primary practice location

41206 N Mill Dr
Magnolia, TX 77354-1874

Mailing address

8696 Sunset Heights LN
Conroe, TX 77302-3457
Phone (281) 414-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1629433685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8696 SUNSET HEIGHTS LN",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773023457",
            "telephone_number": "281-414-3830",
            "fax_number": "936-703-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41206 N MILL DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541874",
            "telephone_number": "936-273-3226",
            "fax_number": "936-273-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.