Gina Caleap, FNP
Individual provider Active NPI Nurse Practitioner · Azle, TX
NPI 1720458482 · NPPES record last updated Mar 7, 2020
Key facts
- NPI
- 1720458482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP144103 (TX)
- Practice address
- 313 Timberlake Dr
Azle, TX 76020-4043 - Phone
- (682) 288-8336
- NPI assigned
- Oct 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
610 Uptown Blvd
Suite 4200
Cedar Hill, TX 75104-3534
Phone (682) 283-3915
Hospital & facility affiliations
- Holistat LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Holistat LLC |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) Corporate Officer (100%) Corporate Director (100%) W-2 Managing Employee (100%) Operational/Managerial Control (100%) |
Feb 17, 2021 Feb 17, 2021 Feb 17, 2021 Feb 1, 2021 Feb 17, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220623000860 | TX | Practitioner - Nurse Practitioner | 9133559610 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holistat LLC | Current |
Accepting new patients |
Locations
3610 W Pioneer Pkwy
Ste 101
Pantego, TX 76013
Phone (682) 200-7472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP144103 | TX | Yes |
Addresses
Primary practice location
313 Timberlake Dr
Azle, TX 76020-4043
Mailing address
313 Timberlake Dr
Azle, TX 76020-4043
Phone (682) 288-8336
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ginacaleap358@gmail.com |
Other providers in Azle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.