ISLAND MEDICAL CLINIC, LLC (NPI# 1174855324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174855324 |
| Entity Type | Organization |
| Organization Name | ISLAND MEDICAL CLINIC, LLC |
| Practice Address |
9009 Boone Rd Houston TX 77099-2033 |
| Mailing Address |
750 Old Hickory Blvd Suite 2-100 Brentwood TN 37027-4528 |
| Practice Telephone | 7132710000 |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |
| Authorized Official Name | MR. WILLIAM B ROUSE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6153766200 |
| Is Organization Subpart | Y |
| Parent Organization Name | CONTINUUM CLINICAL SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194293969 | Island Medical Clinic, LLC | Clinic/Center | 5800 Padre Blvd Ste 113, South Padre Island, TX 78597-7615 | 2018-11-09 |
| Street Address |
9009 BOONE RD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77099-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336310556 | Liberty Island Personal Care Home | Community Based Residential Treatment Facility, Mental Illness | 9009 Boone Rd, Houston, TX 77099-2033 | 2008-03-15 |
| 1093281933 | Recovery Solution Centers | Psychiatry & Neurology | 9009 Boone Rd, Houston, TX 77099-2033 | 2018-10-18 |
| 1003184813 | Johnson & Daughters, Inc. | Clinic/Center | 9009 Boone Rd, Houston, TX 77099-2033 | 2011-12-07 |
| 1164693388 | Liberty Island Adult Day Care | Community Based Residential Treatment Facility, Mental Illness | 9009 Boone Rd, Houston, TX 77099-2033 | 2008-03-15 |
| 1972774198 | Nuvision Behavioral Health Center | Health Maintenance Organization | 9009 Boone Rd, Houston, TX 77099-2033 | 2008-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566688 | Olajumoke Foluke Ajayi | Home Health | 9555 West Sam Houston Pwky S., 410, Houston, TX 77099 | 2020-07-23 |
| 1215580998 | Unity Adult Day Care | Health Maintenance Organization | 11522 South Drive, Houston, TX 77099 | 2019-07-22 |
| 1700340122 | Goshen Living Inc | Home Health | 11735 South Glen Drive #1003, Houston, TX 77099 | 2019-01-30 |
| 1306300140 | Nicanora Celsa Cuellar | Social Worker | 9810 West Sam Houston Parkway South, Suite 200, Houston, TX 77099 | 2019-01-25 |
| 1396223913 | Goshen Living Inc | Home Health | 11735 South Glen Drive, 1003, Houston, TX 77099 | 2018-08-06 |
| 1043724768 | Tj Brothers Pharmacy | Pharmacy | 10910 W. Bellfort Ave, Houston, TX 77099 | 2017-11-17 |
| 1427599042 | Patricio Gutierrez Magpali Jr. | Physical Therapist | 12030 Spring Grove Drive, Houston, TX 77099 | 2017-03-15 |
| 1790157709 | Rosemary Ngozi Ofili | Nurse Practitioner | 9644 Court Lane Drive, West Family Clinic, Houston, TX 77099 | 2015-10-29 |
| 1649670795 | Rochelle Ann Wright | Preferred Provider Organization | 11045 Lands Walk, 102, Houston, TX 77099 | 2014-08-26 |
| 1558792838 | Speaking Out Loud Speech Therapy Services, Pllc | Speech-Language Pathologist | 10960 Stancliff Road, Houston, TX 77099 | 2013-12-11 |
| Find all providers in zip 77099 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790303196 | Restorative Health, LLC | Nurse Practitioner | 4654 Highway 6 N Ste 308, Houston, TX 77084-2879 | 2020-07-12 |
| 1487271623 | Lasean Denise Radway | Nurse Practitioner | 12727 Featherwood Dr Ste 103, Houston, TX 77034-4907 | 2020-07-04 |
| 1285275412 | Sonia Bassett | Nurse Practitioner | 12314 Knobcrest Dr, Houston, TX 77070-2438 | 2019-09-29 |
| 1255987152 | Seema Sadhwani Aggarwal | Nurse Practitioner | 6901 Bertner Ave # 535-c, Houston, TX 77030-3901 | 2019-08-15 |
| 1588134134 | Latrice Milbourne | Nurse Practitioner | 2727 Travis St # 728, Houston, TX 77006-3533 | 2018-11-27 |
| 1356836779 | Hassanat Hassan | Nurse Practitioner | 8123 Barnes Ridge Ln, Houston, TX 77072-0105 | 2018-06-27 |
| 1255844932 | Laura Ogbechie | Nurse Practitioner | 6770 Bertner Ave., C330, Houston, TX 77030-2604 | 2017-11-16 |
| 1831609528 | Ifeoma Jennifer Ukwamedua | Nurse Practitioner | 14611 Wynbourn Way, Houston, TX 77083-4700 | 2017-10-06 |
| 1538697289 | Norma E Puente | Nurse Practitioner | 9242 Buffalo Bend Ln, Houston, TX 77089-5800 | 2017-05-25 |
| 1467992719 | Omobolanle Mutiat Sofowora-austin | Nurse Practitioner | 2828 Hayes Rd Apt 734, Houston, TX 77082-6637 | 2017-03-06 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.