NPIMap

Organization Active NPI

Winnie Community Hospital LLC

Doing business as Riceland Psychiatric Clinic

  • Psychiatry Physician
  • Beaumont, TX
National Provider Identifier
1003690413
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WINNIE COMMUNITY HOSPITAL LLC
Doing business as
Riceland Psychiatric Clinic
Practice address
3560 Delaware St Ste 502
Beaumont, TX 77706-3061
Phone
(409) 899-4472
Fax
(409) 899-9795
NPI assigned
Aug 24, 2023
Last updated
Sep 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Shake Haque
Title
Corporate Coordinator
Phone
(409) 730-8054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

3560 Delaware St Ste 502
Beaumont, TX 77706-3061

Mailing address

538 Broadway
Winnie, TX 77665-7600
Phone (409) 296-6000

Other practice location 1

85 Ih 10 N Ste 104
Beaumont, TX 77707-2539
Phone (409) 899-4472

Other names 1

  • Riceland Psychiatric Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000349 TX Part B Supplier - Clinic/Group Practice 3375440894 Receives reassigned benefits from 31 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winnie, TX; Vidor, TX; Silsbee, TX; Port Arthur, TX; Nederland, TX; Beaumont, TX

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Winnie Comm Hospital LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

87 Ih 10 N
Ste 104
Beaumont, TX 77707

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1003690413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 BROADWAY",
            "city": "WINNIE",
            "state": "TX",
            "postal_code": "776657600",
            "telephone_number": "409-296-6000",
            "fax_number": "409-396-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST STE 502",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063061",
            "telephone_number": "409-899-4472",
            "fax_number": "409-899-9795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Ih 10 N Ste 104",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777072539",
            "country_code": "US",
            "telephone_number": "409-899-4472",
            "fax_number": "409-889-9795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WINNIE COMMUNITY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "SHAKE",
        "authorized_official_title_or_position": "CORPORATE COORDINATOR",
        "authorized_official_telephone_number": "409-730-8054"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riceland Psychiatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.