Covenant Mobile Healthcare LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COVENANT MOBILE HEALTHCARE LLC

Practice address

Family First Primary Care
732 E. Henderson Rd
Angleton, TX 77515

Phone

(979) 248-1586

Fax

(979) 318-5594

NPI assigned

May 25, 2017

Organization subpart

Yes

Parent organization

COVENANT MOBILE HEALTHCARE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Stephen Wayne Ricks Jr., FNP-CNPI 1992254726

Title

President

Phone

(979) 248-1586

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family First Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Covenant Mobile Healthcare LLC

Locations

Practitioners 1

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

• Stephen Ricks Jr., FNP

  • Family Nurse Practitioner
  • Angleton, TX
  • NPI 1992254726
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1922536671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 E HENDERSON RD",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775158463",
            "telephone_number": "979-248-1586",
            "fax_number": "979-318-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAMILY FIRST PRIMARY CARE",
            "address_2": "732 E. HENDERSON RD",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "77515",
            "telephone_number": "979-248-1586",
            "fax_number": "979-318-5594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 Harbor Dr",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "TX",
            "postal_code": "775778716",
            "country_code": "US",
            "telephone_number": "979-248-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COVENANT MOBILE HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT MOBILE HEALTHCARE LLC",
        "enumeration_date": "2017-05-25",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-248-1586",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3675498",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family First Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family First Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Nurse Practitioner in Angleton, TX
• Providers in Angleton, TX by specialty
• Family Nurse Practitioner in Texas

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