NPIMap

Organization Active NPI

Community Wellness Clinic, LLP

  • Ambulatory Family Planning Facility
  • Conroe, TX
National Provider Identifier
1902269715
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
COMMUNITY WELLNESS CLINIC, LLP
Practice address
201 Enterprise Row
Suite 12
Conroe, TX 77301-4448
Phone
(936) 760-2784
Fax
(936) 760-1950
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Mr. Kerry Gregory
Title
Vice-President
Phone
(936) 760-2797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X Primary

Addresses

Primary practice location

201 Enterprise Row
Suite 12
Conroe, TX 77301-4448

Mailing address

201 Enterprise Row
Suite 12
Conroe, TX 77301-4448
Phone (936) 760-2784

Other identifiers 1

IdentifierTypeStateIssuer
018986205MedicaidTX

Other names 1

  • Community Wellness Clinic Family Planning Services Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Wellness Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1902269715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ENTERPRISE ROW",
            "address_2": "SUITE 12",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773014448",
            "telephone_number": "936-760-2784",
            "fax_number": "936-760-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ENTERPRISE ROW",
            "address_2": "SUITE 12",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773014448",
            "telephone_number": "936-760-2784",
            "fax_number": "936-760-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY WELLNESS CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "936-760-2797",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018986205",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Wellness Clinic Family Planning Services Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Community Wellness Clinic Family Planning Services Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.