NPIMap

Organization Active NPI

Health and Human Services Commission

Doing business as North Texas State Hospital/Vernon

  • Clinical Neuropsychologist
  • Vernon, TX
National Provider Identifier
1043314263
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
HEALTH AND HUMAN SERVICES COMMISSION
Doing business as
North Texas State Hospital/Vernon
Practice address
4730 College Drive
Vernon, TX 76384-4009
Phone
(940) 552-9901
Fax
(940) 553-2523
NPI assigned
Sep 8, 2006
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Kristy Carr
Title
Associate Commissioner
Phone
(512) 814-6942

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Nurse Practitioner 363L00000X TX
Clinical Nurse Specialist 364S00000X TX
Clinical Neuropsychologist 103G00000X Primary
Psychologist 103T00000X TX
Clinical Psychologist 103TC0700X TX
Forensic Psychologist 103TF0200X TX
Pharmacist 183500000X TX
Forensic Psychiatry Physician 2084F0202X TX
Psychiatry Physician 2084P0800X TX
Child & Adolescent Psychiatry Physician 2084P0804X TX
Geriatric Psychiatry Physician 2084P0805X TX
General Practice Physician 208D00000X TX

Addresses

Primary practice location

4730 College Drive
Vernon, TX 76384-4009

Mailing address

4110 Guadalupe St
MC-2023
Austin, TX 78751-4296
Phone (512) 206-5284

Other identifiers 7

IdentifierTypeStateIssuer
1301640-07MedicaidTX
1081036-01MedicaidTX
HH3011OtherTXBCBS ADOLESCENT
1081036-02MedicaidTX
4539219OtherTXPHARMACY NCPDP NUMBER
HH4008OtherTXBCBS FORENSIC
0211963-01MedicaidTX

Other names 1

  • North Texas State Hospital/Vernon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170908001058 TX Part B Supplier - Clinic/Group Practice 2163795824 Receives reassigned benefits from 462 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lubbock, TX; Mexia, TX; Pollock, TX; Richmond, TX; Rusk, TX; San Antonio, TX; Terrell, TX; Vernon, TX…

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1043314263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 GUADALUPE ST",
            "address_2": "MC-2023",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514296",
            "telephone_number": "512-206-5284",
            "fax_number": "512-206-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 COLLEGE DRIVE",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763844009",
            "telephone_number": "940-552-9901",
            "fax_number": "940-553-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND HUMAN SERVICES COMMISSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "ASSOCIATE COMMISSIONER",
        "authorized_official_telephone_number": "512-814-6942"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301640-07",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081036-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ADOLESCENT",
            "identifier": "HH3011",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081036-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NCPDP NUMBER",
            "identifier": "4539219",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FORENSIC",
            "identifier": "HH4008",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211963-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Texas State Hospital/Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.