NPIMap

Organization Active NPI

Collaborative Geriatrics Inc

  • Gerontology Nurse Practitioner
  • Katy, TX
National Provider Identifier
1811088628
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
COLLABORATIVE GERIATRICS INC
Practice address
24285 Katy Fwy Ste 300
Katy, TX 77494-1327
Phone
(346) 387-7171
Fax
(844) 703-5305
NPI assigned
Sep 27, 2006
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Rhonda Hunsucker, A/GNP-CNPI 1962415638
Title
Owner
Phone
(281) 723-9068

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Adult Health Nurse Practitioner 363LA2200X NU
Gerontology Nurse Practitioner 363LG0600X NU Primary

Addresses

Primary practice location

24285 Katy Fwy Ste 300
Katy, TX 77494-1327

Mailing address

24285 Katy Fwy Ste 300
Katy, TX 77494-1327
Phone (346) 387-7171

Other practice location 1

24275 Katy Fwy Ste 400
Katy, TX 77494-7267
Phone (346) 387-7171

Other identifiers 3

IdentifierTypeStateIssuer
184735201MedicaidTX
0032PLOtherTXBCBS
DG9243OtherTXRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070426000586 TX Part B Supplier - Clinic/Group Practice 5193827046 Receives reassigned benefits from 76 practitioners
Practice locations: Katy, TX; Manvel, TX; Pearland, TX; Richmond, TX; Sugarland, TX; Wharton, TX; Houston, TX; El Campo, TX

National Provider Directory

National Provider Directory

Locations

11395 Richmond Ave
Houston, TX 77082
Phone (281) 759-2900

Vibralife Katy
1223 Park W Greene Dr
Katy, TX 77493
Phone (346) 762-6300

Practitioners & affiliated clinicians

Practitioners 78

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.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1811088628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941327",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941327",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24275 Katy Fwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774947267",
            "country_code": "US",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLABORATIVE GERIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "HUNSUCKER",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-723-9068",
        "authorized_official_credential": "A/GNP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184735201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0032PL",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DG9243",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.