Athena Medical Clinic LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ATHENA MEDICAL CLINIC LLC

Practice address

30575 Kingsland Blvd # 150
Brookshire, TX 77423-2844

Phone

(281) 717-4674

NPI assigned

Aug 31, 2022

Last updated

Jun 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Iolani Mae Sy Aves, NPNPI 1710464748

Title

Managing Member

Phone

(713) 584-9013

Specialties & licenses 1

Addresses

Other names 1

• Athena medical clinic LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Iolani Mae S Aves

  • Nurse Practitioner
  • Brookshire, TX
  • NPI 1710464748
  Medicare reassignment Care Compare group NPD Authorized official
• Senthilnayaki Kasiraja

  • Primary Care Nurse Practitioner
  • Brookshire, TX
  • NPI 1346868536
  Medicare reassignment Care Compare group NPD
• Danielle Marie Inferrera, FNP-C

  • Family Medicine Physician
  • Cypress, TX
  • NPI 1174313795
  NPD
• Dunia Altameemi, PA-C

  • Physician Assistant
  • Brookshire, TX
  • NPI 1962270512
  NPD (past)

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1760102644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30575 KINGSLAND BLVD # 150",
            "city": "BROOKSHIRE",
            "state": "TX",
            "postal_code": "774232844",
            "telephone_number": "281-717-4674",
            "fax_number": "833-318-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30575 KINGSLAND BLVD # 150",
            "city": "BROOKSHIRE",
            "state": "TX",
            "postal_code": "774232844",
            "telephone_number": "281-717-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "AVES",
        "authorized_official_first_name": "IOLANI MAE",
        "authorized_official_middle_name": "SY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "713-584-9013",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athena medical clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Athena medical clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dunia Altameemi, PA-C
• Shirley Adaeze Amanfo, NP
• Latisha Renea Amos, DC, FNP
• Anointed Hands Home Healthcare
• Apex Connect Integrative Medicine
• Athena Testosterone and Weight Loss PLLC
• Iolani Mae S Aves
• Penelope L Barahona Vega, SENIOR CAREGIVER
• Adrianna Alexandra Barber, LPC
• Candezz Bell

• Nurse Practitioner in Brookshire, TX
• Providers in Brookshire, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.