NPIMap

Organization Active NPI

Lamar University Student Health Ctr

  • Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1003129891
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
618115 Issued in TX
Legal business name
LAMAR UNIVERSITY STUDENT HEALTH CTR
Practice address
857 E Virginia St
Beaumont, TX 77705-5546
Phone
(409) 880-8466
Fax
(409) 880-7703
NPI assigned
Jul 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shawn Gray, RNMSNENPNPI 1578513040
Title
Coordinator/Nurse
Phone
(409) 880-8466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 618115 TX Primary

Addresses

Primary practice location

857 E Virginia St
Beaumont, TX 77705-5546

Mailing address

P O Box 10015
857 E Virginia
Beaumont, TX 77710-5546
Phone (409) 880-8466

National Provider Directory

National Provider Directory
Tax ID family
Lamar University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

857 E Virginia St
Beaumont, TX 77705
Phone (409) 880-8465

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1003129891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 10015",
            "address_2": "857 E VIRGINIA",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777105546",
            "telephone_number": "409-880-8466",
            "fax_number": "409-880-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 E VIRGINIA ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777055546",
            "telephone_number": "409-880-8466",
            "fax_number": "409-880-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMAR UNIVERSITY STUDENT HEALTH CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "COORDINATOR/NURSE",
        "authorized_official_telephone_number": "409-880-8466",
        "authorized_official_credential": "RNMSNENP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "618115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.