Organization Active NPI

Wellness Care Center of Denton LTD

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lewisville, TX
National Provider Identifier
1912000472
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
WELLNESS CARE CENTER OF DENTON LTD
Practice address
701 S Charles St
Lewisville, TX 75057-4612
Phone
(469) 831-2541
Fax
(800) 669-2161
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Mrs. Deborah Diane Durham
Title
Administrator
Phone
(469) 831-2541

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

701 S Charles St
Lewisville, TX 75057-4612

Mailing address

701 S Charles St
Lewisville, TX 75057-4612
Phone (940) 243-9500

Other identifiers 1

IdentifierTypeStateIssuer
172474201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040810001178 TX Part A Provider - Comprehensive Outpatient Rehabilitation Facility 6507838513 Practice locations: Lewisville, TX

National Provider Directory

National Provider Directory

Locations

4851 S Interstate 35 E
Bldg C104
Corinth, TX 76210
Phone (940) 497-8700

3200 Colorado Blvd
Ste 103
Denton, TX 76210
Phone (940) 243-9500

701 S Charles St
Lewisville, TX 75057
Phone (469) 831-2541

Practitioners & affiliated clinicians

Practitioners 1

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1912000472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S CHARLES ST",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750574612",
            "telephone_number": "940-243-9500",
            "fax_number": "008-669-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S CHARLES ST",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750574612",
            "telephone_number": "469-831-2541",
            "fax_number": "800-669-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CARE CENTER OF DENTON LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-831-2541",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172474201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.