IMPACT HEALTH DIRECT PRIMARY CARE, PLLC (NPI# 1760004188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760004188 |
| Entity Type | Organization |
| Organization Name | IMPACT HEALTH DIRECT PRIMARY CARE, PLLC |
| Practice Address |
1905 W Ennis Ave Ste 504b Ennis TX 75119-3630 |
| Practice Telephone | 9728464800 |
| Practice Fax Number | 4102376747 |
| Mailing Telephone | 9728464800 |
| Mailing Fax Number | 4102376747 |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |
| Authorized Official Name | DR. KARA SJOGREN (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 9728464800 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
1905 W ENNIS AVE STE 504B |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669608493 | Ennis Pediatric and Adolescent Health Care Center, P.a. | Clinic/Center | 2203 W Lampasas St, Suite 202, Ennis, TX 75119-5644 | 2009-06-08 |
| 1073748562 | Dr. Fredric Puckett, Pllc | Clinic/Center | 2203 W Lampasas St, Suite 101, Ennis, TX 75119-5644 | 2009-05-27 |
| 1831397827 | Blair Family Medicine Pa | Clinic/Center | 2203 W Lampasas St Ste 101, Ennis, TX 75119-5644 | 2007-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323568 | Synergenx Health - Webster LLC | Clinic/Center | 19325 Gulf Fwy Ste 120, Webster, TX 77598-2812 | 2020-10-16 |
| 1821696253 | Bio Drip, LLC | Clinic/Center | 935 Sunland Park Dr Ste 103, El Paso, TX 79922-1369 | 2020-10-16 |
| 1821696386 | Blue Ocean Health Services LLC | Clinic/Center | 105 Clariden Ranch Rd, Southlake, TX 76092-1947 | 2020-10-15 |
| 1982202800 | Devoted Medical Group of Texas, Inc. | Clinic/Center | 20405 State Highway 249 Ste 325, Houston, TX 77070-2893 | 2020-10-13 |
| 1891392437 | Blum Health Pllc | Clinic/Center | 1387 George Dieter Dr Ste 106d, El Paso, TX 79936-7410 | 2020-10-06 |
| 1902403769 | Apogee Health Promotions | Clinic/Center | 105 Cottage Rd # B, Carthage, TX 75633-1507 | 2020-10-05 |
| 1447857255 | Fairgrounds Family Clinic Pllc | Clinic/Center | 4505 Hummingbird Ln N, Harlingen, TX 78552-2422 | 2020-10-05 |
| 1508463605 | Kk Martinez & Associates LLC | Clinic/Center | 13180 Fm 529 Rd Ste A, Houston, TX 77041-2652 | 2020-10-02 |
| 1659987022 | Specialists In Geriatric and Palliative Care Medicine Pllc | Clinic/Center | 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 | 2020-09-21 |
| 1518573443 | Elizabeth Danielle Benavides | Clinic/Center | 1424 Tanager Ct, San Antonio, TX 78260-2455 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on IMPACT HEALTH DIRECT PRIMARY CARE, PLLC.
| 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.