Active NPI
Atrium House Call Clinic, LLC
- Community Health Nurse Practitioner
- Dallas, TX
National Provider Identifier
1659914539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Nurse Practitioner
- Legal business name
- ATRIUM HOUSE CALL CLINIC, LLC
- Practice address
- 10729 Audelia Rd Ste 210
Dallas, TX 75238-1000 - Phone
- (972) 270-1145
- NPI assigned
- Oct 23, 2019
- 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
- Gideon Ahanonu
- Title
- Provider
- Phone
- (214) 564-8159
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Nurse Practitioner | 363LC1500X | Primary |
Addresses
Primary practice location
10729 Audelia Rd Ste 210
Dallas, TX 75238-1000
Mailing address
9550 Forest LN Ste 619
Dallas, TX 75243-5905
Phone (972) 439-5208
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | secure | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220308001017 | TX | Part B Supplier - Clinic/Group Practice | 6305230327 |
Receives reassigned benefits from 4 practitioners Practice locations: Dallas, TX |
National Provider Directory
National Provider DirectoryLocations
9550 Forest Ln
Ste 619
Dallas, TX 75243
Phone (972) 439-5208
Practitioners & affiliated clinicians
Practitioners 4
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": "1571788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1645056000000",
"number": "1659914539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9550 FOREST LN STE 619",
"city": "DALLAS",
"state": "TX",
"postal_code": "752435905",
"telephone_number": "972-439-5208",
"fax_number": "214-617-0503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10729 AUDELIA RD STE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752381000",
"telephone_number": "972-270-1145"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATRIUM HOUSE CALL CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-23",
"last_updated": "2022-02-17",
"certification_date": "2022-02-16",
"status": "A",
"authorized_official_last_name": "AHANONU",
"authorized_official_first_name": "GIDEON",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "214-564-8159"
},
"taxonomies": [
{
"code": "363LC1500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Community Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "secure",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9550 Forest Ln Ste 619",
"city": "Dallas",
"state": "TX",
"country_code": "US",
"postal_code": "752435905",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.