Organization Active NPI

Healing Hands Wound Clinic LLC

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1699553495
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEALING HANDS WOUND CLINIC LLC
Practice address
9223 Wild River Dr
Arlington, TX 76002-5022
Phone
(267) 738-1375
NPI assigned
Sep 21, 2023
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Ron J Philipose, FNPNPI 1063995660
Title
Owner/Provider
Phone
(267) 738-1375

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)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

9223 Wild River Dr
Arlington, TX 76002-5022

Mailing address

9223 Wild River Dr
Arlington, TX 76002-5022
Phone (267) 738-1375

Other practice location 1

1900 Matlock Rd Ste 304
Mansfield, TX 76063-4435
Phone (267) 738-1375

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240212000668 TX Part B Supplier - Clinic/Group Practice 1052754652 Receives reassigned benefits from 3 practitioners
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

1830 E Broad St
Ste 102
Mansfield, TX 76063
Phone (817) 380-3201

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1699553495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9223 WILD RIVER DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760025022",
            "telephone_number": "267-738-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9223 WILD RIVER DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760025022",
            "telephone_number": "267-738-1375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Matlock Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760634435",
            "country_code": "US",
            "telephone_number": "267-738-1375",
            "fax_number": "817-886-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALING HANDS WOUND CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "PHILIPOSE",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "267-738-1375",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.