NPIMap

Organization Active NPI

Pecos County Memorial Hospital

  • Anesthesiology Physician
  • Fort Stockton, TX
National Provider Identifier
1033486915
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
000356 Issued in TX
Legal business name
PECOS COUNTY MEMORIAL HOSPITAL
Practice address
387 W Ih 10
Fort Stockton, TX 79735
Phone
(432) 336-2400
NPI assigned
Nov 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Betsy Briscoe, COE
Title
Director
Phone
(432) 336-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X 000356 TX Primary

Addresses

Primary practice location

387 W Ih 10
Fort Stockton, TX 79735

Mailing address

387 W Ih 10
Fort Stockton, TX 79735-2700
Phone (432) 336-2004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000269 TX Part B Supplier - Clinic/Group Practice 0446160733 Receives reassigned benefits from 24 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Stockton, TX; Sanderson, TX

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Pecos County Memorial4 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.

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/pecos-a6289fb5

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": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1033486915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797352700",
            "telephone_number": "432-336-2004",
            "fax_number": "844-315-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "432-336-4200",
        "authorized_official_credential": "COE"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "000356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.