Willybroad Che, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP137559 Issued in TX

Practice address

1341 W Mockingbird LN
Dallas, TX 75247-6913

Phone

(972) 630-4810

NPI assigned

Apr 6, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medinet Healthcare Agency IncGroup PAC ID 7416257175, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medinet Healthcare Agency Inc

  • Family Medicine Physician
  • Addison, TX
  • NPI 1942671573
  Medicare reassignment Care Compare group NPD
• Pariscare Home Health Agency LLC

  • Home Health Agency
  • Garland, TX
  • NPI 1548946262
  NPD Authorized official

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1770046807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 LONG MEADOW RD",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980290",
            "telephone_number": "469-286-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476913",
            "telephone_number": "972-630-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHE",
        "first_name": "WILLYBROAD",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHB Pharmacy
• CHC Care Specialty Pharmacy and Consultants LLC
• CHC Services, Inc.
• CHCC Inc
• CHCC Inc.
• Theiry Chea, PHARMD
• Randi J. Cheatham-Johnson, PHD
• Cheatham-Moffett Karingbridge Konnection
• Brooke A. Cheatham, CRNA
• David Alan Cheatham, M.D.

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.