Waco Bluebonnet Holdings, Inc.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

WACO BLUEBONNET HOLDINGS, INC.

Doing business as

Bluebonnet Health Services Supportive Care

Practice address

307 Londonderry Dr
Waco, TX 76712-7915

Phone

(254) 751-1790

Fax

(254) 751-7295

NPI assigned

Mar 14, 2025

Last updated

Mar 14, 2025By 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

Brent McKenzie

Title

Cfo

Phone

(254) 772-5577

Specialties & licenses 1

Addresses

Other names 1

• Bluebonnet Health Services Supportive Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Waco Bluebonnet Holdings, Inc.

  dba Bluebonnet Health Services of Waco

  • Home Health Agency
  • Waco, TX
  • NPI 1629136742

  1153447909

  Same PAC ID
• Waco Bluebonnet Holdings, Inc.

  dba Bluebonnet Health Services

  • Community Based Hospice Care Agency
  • Waco, TX
  • NPI 1902968464

  1153447909

  Same PAC ID

Tax ID family

Blue Bonnet Hospice Home Care Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Waco Bluebonnet Holdings, Inc.

  dba Bluebonnet Health Services of Waco

  • Home Health Agency
  • Waco, TX
  • NPI 1629136742
  NPD tax ID
• Waco Bluebonnet Holdings, Inc.

  dba Bluebonnet Health Services

  • Community Based Hospice Care Agency
  • Waco, TX
  • NPI 1902968464
  NPD tax ID

Locations

Practitioners 2

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.

• Janis Kay Giles, FNP

  • Family Nurse Practitioner
  • Waco, TX
  • NPI 1871585737
  Medicare reassignment NPD
• Laura Ruth Wright, ED.D

  • Clinical Psychologist
  • Waco, TX
  • NPI 1295777134
  NPD (past)

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1760282289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127915",
            "telephone_number": "254-751-1790",
            "fax_number": "254-751-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127915",
            "telephone_number": "254-751-1790",
            "fax_number": "254-751-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO BLUEBONNET HOLDINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "254-772-5577"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebonnet Health Services Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.