NPIMap

Organization Active NPI

Wellspring CV, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Houston, TX
National Provider Identifier
1801409529
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
WELLSPRING CV, LLC
Practice address
5373 W Alabama Street
Ste 204
Houston, TX 77056
Phone
(713) 714-4040
Fax
(713) 588-1850
NPI assigned
Aug 24, 2020
Last updated
Aug 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Dr. Cornelius Davis, MDNPI 1528037975
Title
Owner
Phone
(713) 714-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

5373 W Alabama Street
Ste 204
Houston, TX 77056

Mailing address

PO Box 2868
Bellaire, TX 77402-2868
Phone (713) 714-4040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1801409529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774022868",
            "telephone_number": "713-714-4040",
            "fax_number": "713-588-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 W ALABAMA STREET",
            "address_2": "STE 204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77056",
            "telephone_number": "713-714-4040",
            "fax_number": "713-588-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING CV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CORNELIUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-714-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.