NPIMap

Organization Active NPI

Graham Regional Medical Center

Doing business as Jacksboro Rural Health Clinic

  • General Acute Care Hospital
  • Jacksboro, TX
National Provider Identifier
1003965260
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
458585 Issued in TX
Legal business name
GRAHAM REGIONAL MEDICAL CENTER
Doing business as
Jacksboro Rural Health Clinic
Practice address
611 N 4TH St
Jacksboro, TX 76458-1113
Phone
(940) 549-3400
NPI assigned
Jan 9, 2007
Last updated
Sep 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Authorized official

Name
Bonnie Blevins
Title
Cfo
Phone
(940) 549-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 458585 TX Primary

Addresses

Primary practice location

611 N 4TH St
Jacksboro, TX 76458-1113

Mailing address

PO Box 1390
Graham, TX 76450-1390
Phone (940) 549-3400

Other names 1

  • Jacksboro Rural Health Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

523 Elm St
Graham, TX 76450
Phone (940) 549-2672

Practitioners & affiliated clinicians

Practitioners 5

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1003965260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1390",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764501390",
            "telephone_number": "940-549-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N 4TH ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581113",
            "telephone_number": "940-549-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "940-549-3400"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "458585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksboro Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.