Profoundly Impacting People, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PROFOUNDLY IMPACTING PEOPLE, INC.

Practice address

2622 Crystal Falls Dr
Pearland, TX 77584-2508

Phone

(713) 436-7149

NPI assigned

May 2, 2019

Organization subpart

No

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

Authorized official

Name

Kimberly Pipkin-WilderNPI 1407496227

Title

President

Phone

(832) 724-1374

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Pipkin Wilder

  • Nursing Home Administrator
  • Houston, TX
  • NPI 1407496227
  NPD Authorized official

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1770148041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84136",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775840018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 CRYSTAL FALLS DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775842508",
            "telephone_number": "713-436-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUNDLY IMPACTING PEOPLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "PIPKIN-WILDER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-724-1374"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pearland, TX
• Providers in Pearland, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.