Organization Active NPI

CR Mobile Wound Care LLC

  • Primary Care Nurse Practitioner
  • Bellaire, TX
National Provider Identifier
1700628294
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
CR MOBILE WOUND CARE LLC
Practice address
6575 West Loop S Ste 500
Bellaire, TX 77401-3509
Phone
(713) 487-5233
Fax
(713) 513-5311
NPI assigned
Jun 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Uloma ChiakweluNPI 1184106080
Title
Administrator
Phone
(832) 423-4472

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

6575 West Loop S Ste 500
Bellaire, TX 77401-3509

Mailing address

6575 West Loop S Ste 500
Bellaire, TX 77401-3509
Phone (713) 487-5233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240909000408 TX Part B Supplier - Clinic/Group Practice 1658811484 Receives reassigned benefits from 1 practitioner
Practice locations: Bellaire, TX

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": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1700628294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6575 WEST LOOP S STE 500",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013509",
            "telephone_number": "713-487-5233",
            "fax_number": "713-513-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6575 WEST LOOP S STE 500",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013509",
            "telephone_number": "713-487-5233",
            "fax_number": "713-513-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CR MOBILE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "CHIAKWELU",
        "authorized_official_first_name": "ULOMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-423-4472"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.