NPIMap

Organization Active NPI

Whboutique Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tyler, TX
National Provider Identifier
1780086371
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1001440 Issued in TX
Legal business name
WHBOUTIQUE INC.
Practice address
1130 Doctors Dr
Tyler, TX 75701-2123
Phone
(903) 533-1103
Fax
(903) 533-1104
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Authorized official

Name
Vicki D Jones
Title
President/Ceo
Phone
(903) 758-9904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1001440 TX Primary

Addresses

Primary practice location

1130 Doctors Dr
Tyler, TX 75701-2123

Mailing address

605 N 6TH St
Longview, TX 75601-6606
Phone (903) 758-9904

Other identifiers 2

IdentifierTypeStateIssuer
1001440OtherTXTEXAS DEVICE LICENSE
534205OtherTXBCBS

Other names 1

  • Women's Health Boutique Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL sharon@mywhb.com
Direct Messaging Address sharon@mywhb.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150720002248 TX DME Supplier - Medical Supply Company 9032347679 Practice locations: Tyler, TX

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Women'S Health Boutique1130 Doctors Dr, Tyler, TX 75701-2123(903) 533-1103 Neuromuscular Elect Stimulators (NMES)/Supplies|Pneumatic Compression Devices and/or Supplies|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Surgical Dressings|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 2014

National Provider Directory

National Provider Directory
Tax ID family
Whboutique Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

8499 Greenville Ave
Ste 105
Dallas, TX 75231
Phone (214) 373-1045

605 N 6th St
Longview, TX 75601
Phone (903) 757-2201

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1780086371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N 6TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016606",
            "telephone_number": "903-758-9904",
            "fax_number": "903-236-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 DOCTORS DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012123",
            "telephone_number": "903-533-1103",
            "fax_number": "903-533-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHBOUTIQUE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "903-758-9904"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1001440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEVICE LICENSE",
            "identifier": "1001440",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "534205",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sharon@mywhb.com",
            "affiliation": "N",
            "address_1": "1130 Doctors Dr",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757012123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sharon@mywhb.com",
            "affiliation": "N",
            "address_1": "1130 Doctors Dr",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757012123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Women's Health Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Women's Health Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.