 Provider Id: Effective Date: Approved On:  Current Status: Inprocess  Initiated On: 2021-03-29  Expected: 2021-06-27  Last FollowUp: 2021-05-26  Next FollowUp: 2021-04-23 Statcare Minor Emergency Clinic (Kingsville) Tax Id: 46-0575924  Main Address: 500 E CAESAR  NPI: 1689924904 Trevino, Rose  NPI: 1437174794  Health Smart    Status Notes Attachments Activity Log   New/Not Initiated2021-03-16Javed,Humair  Initiated2021-03-29Abbas,Adil Email sent to: pr.south@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Health smart for our group Statcare Minor Emergency Clinic under the below mentioned locations.   Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   In Process2021-04-16Abbas,Adil Email sent to: mdiprsupport@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,   Please find the attached CAQH access form for the providers that were requested in your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   In Process2021-05-26Saim,Muhammad We Sent an email to mdiprsupport@healthsmart.com Sub: Enrollment request status - RHC - Health Smart  Hello, We submitted a request for the enrollment of providers under the following group.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  Kindly let us know what is the current status regarding our request as soon as possible.  Thanks   