Organization Active NPI

Wellness Response Inc

  • Home Health Agency
  • Houston, TX
National Provider Identifier
1962620310
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
010505 Issued in TX
Legal business name
WELLNESS RESPONSE INC
Doing business as
WELLNESS HEALTHCARE INC
Practice address
11603 Possum Hollow Lane
Houston, TX 77065-2909
Phone
(832) 437-0217
Fax
(281) 715-5288
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Authorized official

Name
Mrs. Misty P Burkhalter
Title
Owner/President
Phone
(832) 437-0217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 010505 TX Primary

Addresses

Primary practice location

11603 Possum Hollow Lane
Houston, TX 77065-2909

Mailing address

11603 Possum Hollow Lane
Houston, TX 77065-2909
Phone (832) 437-0217

Other identifiers 2

IdentifierTypeStateIssuer
001018529MedicaidTX
010505OtherTXTEXAS DEPT OF AGING AND DISABILITY (DADS) LICENSE #

Other names 1

  • WELLNESS HEALTHCARE INC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060418000482 TX Part A Provider - Home Health Agency 8921017096 Practice locations: Houston, TX

Home health agency certification: CCN 747216

Legal name
WELLNESS RESPONSE INC
Doing business as
WELLNESS HEALTHCARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 11, 2009
Last certification
Feb 14, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 24, 2006 in TX
Enrollment address
11603 Possum Hollow LN
Houston, TX 77065-2909

Care Compare: Home health agency

Medicare Care Compare
Listed as
Wellness Healthcare IncCCN 747216
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Sep 11, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1059435Wellness Healthcare Inc11603 Possum Hollow LN, Houston, TX 77065Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory

Locations

5834 Louetta Rd
Ste C2
Spring, TX 77379
Phone (832) 437-0217

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Richille Lancanan Individual W-2 Managing EmployeeAlternate Administrator Feb 25, 2019
Misty Burkhalter Individual 5% Or Greater Direct Ownership InterestCeo Jun 5, 2018 100%
Corporate OfficerCeo Jun 5, 2018
Corporate DirectorCeo Jun 5, 2018
W-2 Managing EmployeeCeo Jun 5, 2018
Wellness Response, Inc Organization, Katy, TX For-profit Operational/Managerial Control Mar 24, 2006 100%

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1962620310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11603 POSSUM HOLLOW LANE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770652909",
            "telephone_number": "832-437-0217",
            "fax_number": "281-715-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11603 POSSUM HOLLOW LANE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770652909",
            "telephone_number": "832-437-0217",
            "fax_number": "281-715-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS RESPONSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "BURKHALTER",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "832-437-0217",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018529",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPT OF AGING AND DISABILITY (DADS) LICENSE #",
            "identifier": "010505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WELLNESS HEALTHCARE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESS HEALTHCARE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.