OLD CORNER WELLNESS INC
NPI 1003514597
Nurse Practitioner - Adult Health in West, TX
About Old Corner Wellness Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLD CORNER WELLNESS INC (NPI 1003514597) is a healthcare organization registered as an adult health in West, Texas and active in the NPI registry since February 2023. The organization lists Randy James Niemeyer, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Old Corner Wellness Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Old Corner Wellness Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Old Corner Wellness Inc's NPI number?
The NPI number for Old Corner Wellness Inc is 1003514597. It was assigned to this organization in the NPPES registry on February 23, 2023.
Where is Old Corner Wellness Inc located?
Old Corner Wellness Inc is located at 200 N Main St, West, TX 76691. The listed phone number is (254) 826-5122.
What is Old Corner Wellness Inc's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Old Corner Wellness Inc enrolled in Medicare?
Yes. Old Corner Wellness Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Old Corner Wellness Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Old Corner Wellness Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Old Corner Wellness Inc was last updated on June 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Old Corner Wellness Inc · NPI 1003514597
Adult Health organization in West, Texas. Organization record, active in the CMS NPPES registry since February 23, 2023.
## Identity
- **NPI:** 1003514597 (Entity type: Organization)
- **Enumerated:** February 23, 2023
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **Organization subpart:** No
- **Authorized official:** Randy Niemeyer, OWNER
## Practice location
- **Address:** 200 N MAIN ST, West, TX 76691-1207
- **Phone:** (254) 826-5122
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1003514597) · Data from the CMS NPPES public registry.