Champion Healthcare Group LLC Dba Rolanda Ford Sole MBR

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

CHAMPION HEALTHCARE GROUP LLC DBA ROLANDA FORD SOLE MBR

Practice address

2850 Eastex Fwy # 100
Beaumont, TX 77703-4645

Phone

(409) 347-8989

Fax

(409) 347-8979

NPI assigned

Feb 7, 2022

Organization subpart

No

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

Authorized official

Name

Brandi Pickering

Title

Credentialing

Phone

(409) 239-9467

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Rolanda Ford, FNP-C

  • Family Nurse Practitioner
  • Beaumont, TX
  • NPI 1316558885
  Medicare reassignment NPD

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1841944196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 EASTEX FWY # 100",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777034645",
            "telephone_number": "409-347-8989",
            "fax_number": "409-347-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 EASTEX FWY # 100",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777034645",
            "telephone_number": "409-347-8989",
            "fax_number": "409-347-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION HEALTHCARE GROUP LLC DBA ROLANDA FORD SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "409-239-9467"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chambers County Public Hospital District No 1
• Alexis Bianca Chambers, ARNP
• Jennifer Rae Chambers, CRNA
• Derek Chambless, CRNA
• Lyonel Champagne, OT
• Heather Champion, LPC
• Tanya R Champion, FNP-C
• Cheryl Gaye Chance, LO CO
• Charukesi Chandrasekaran, MD
• Josef Giovanni Chapman, LICENSED BARBER

• Primary Care Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Primary Care Nurse Practitioner in Texas

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