WHOLELIFE AUTHENTIC CARE PROVIDER NETWORK
NPI 1386200889
General Practice in Fort Worth, TX
About Wholelife Authentic Care Provider Network NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WHOLELIFE AUTHENTIC CARE PROVIDER NETWORK (NPI 1386200889) is a healthcare organization registered as a general practice in Fort Worth, Texas and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through February 22, 2028 and lists Nicole Havrilla, Board President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2172247
Wholelife Authentic Care Provider Network · Fort Worth, TXOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Wholelife Authentic Care Provider Network's NPI number?
The NPI number for Wholelife Authentic Care Provider Network is 1386200889. It was assigned to this organization in the NPPES registry on May 10, 2019.
Where is Wholelife Authentic Care Provider Network located?
Wholelife Authentic Care Provider Network is located at 1000 Bonnie Brae Ave Ste 120, Fort Worth, TX 76111. The listed phone number is (817) 706-3128.
What is Wholelife Authentic Care Provider Network's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Does Wholelife Authentic Care Provider Network hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2172247) is associated with this NPI, valid through February 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wholelife Authentic Care Provider Network accept?
Health plans from WellPoint list Wholelife Authentic Care Provider Network as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Wholelife Authentic Care Provider Network was last updated on June 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Wholelife Authentic Care Provider Network · NPI 1386200889
General Practice organization in Fort Worth, Texas. Organization record, active in the CMS NPPES registry since May 10, 2019.
## Identity
- **NPI:** 1386200889 (Entity type: Organization)
- **Enumerated:** May 10, 2019
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Nicole Havrilla, BOARD PRESIDENT
## Practice location
- **Address:** 1000 BONNIE BRAE AVE STE 120, Fort Worth, TX 76111-4301
- **Phone:** (817) 706-3128
## Record status
- **NPPES last updated:** June 10, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1386200889) · Data from the CMS NPPES public registry.