Individual provider Active NPI

Linda Marie Motherwell, RN

  • Administrator Registered Nurse
  • Nacogdoches, TX
National Provider Identifier
1669642310
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
534217 Issued in TX
Practice address
418 W Main St
Nacogdoches, TX 75961-4814
Phone
(936) 552-1609
NPI assigned
Mar 10, 2008
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 534217 TX Primary

Addresses

Primary practice location

418 W Main St
Nacogdoches, TX 75961-4814

Mailing address

418 W Main St
Nacogdoches, TX 75961-4814
Phone (936) 552-1609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080307000564 TX Part A Provider - Home Health Agency 6608826276 Practice locations: Nacogdoches, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669642310. Details of each certification follow.

Home health agency certification: CCN 457899

Legal name
LINDA MARIE MOTHERWELL
Doing business as
MOTHERWELL HOME HEALTH PROFESSIONALS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 7, 2005
Last certification
Feb 14, 2019
Ownership / control type
Proprietary
Organization structure
Sole ProprietorProprietary
Enrollment address
418 West Main Street
Nacogdoches, TX 75961-4814

Care Compare: Home health agency

Medicare Care Compare
Listed as
Motherwell Home HealthCCN 457899 · All quality measures
Ownership
Proprietary
Certified
Sep 7, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
534217TXMDAdministrator Registered Nurse

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Linda Motherwell Individual 5% Or Greater Direct Ownership InterestOwner Jan 19, 2005 100%
Corporate OfficerOwner Jan 19, 2005 100%
Corporate DirectorOwner Jan 19, 2005 100%
W-2 Managing EmployeeAlt Admin Jan 19, 2005

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1669642310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 W MAIN ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614814",
            "telephone_number": "936-552-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W MAIN ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614814",
            "telephone_number": "936-552-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTHERWELL",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "534217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.