Organization Active NPI

Solid Foundation Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pearland, TX
National Provider Identifier
1801535414
Registry record updated Apr 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOLID FOUNDATION PSYCHIATRY PLLC
Practice address
6302 Broadway St Ste 130
Pearland, TX 77581-7859
Phone
(832) 438-0330
NPI assigned
Jun 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2023

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

Authorized official

Name
Mr. Edewor Bernard Osevwe, PMHNPNPI 1386939429
Title
Ceo
Phone
(832) 438-0330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

6302 Broadway St Ste 130
Pearland, TX 77581-7859

Mailing address

10223 Broadway St Ste P381
Pearland, TX 77584-7880
Phone (281) 720-6272

Other names 1

  • Solid Foundation Psychiatry Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Kareo.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220720001365 TX Part B Supplier - Clinic/Group Practice 0547641680 Receives reassigned benefits from 3 practitioners
Practice locations: Pearland, TX
O20220928000524 AZ Part B Supplier - Clinic/Group Practice 0547641680 Receives reassigned benefits from 1 practitioner
Practice locations: Goodyear, AZ
O20240311000253 CA Part B Supplier - Clinic/Group Practice 0547641680 Receives reassigned benefits from 1 practitioner
Practice locations: Oceanside, CA

National Provider Directory

National Provider Directory

Locations

1111 Bayside Dr
Ste 150
Corona del Mar, CA 92625

10223 Broadway St
Ste P381
Pearland, TX 77584
Phone (832) 774-0815

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682812800000",
    "number": "1801535414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST STE P381",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847880",
            "telephone_number": "281-720-6272",
            "fax_number": "281-720-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 BROADWAY ST STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775817859",
            "telephone_number": "832-438-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLID FOUNDATION PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-04-30",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "OSEVWE",
        "authorized_official_first_name": "EDEWOR",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-438-0330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kareo.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "1111 Bayside Dr Ste 150",
            "city": "Corona Del Mar",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926251714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Solid Foundation Psychiatry",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Solid Foundation Psychiatry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2023; 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.