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Organization Active NPI

Ochiltree Hospital District

Doing business as Ochiltree General Hospital ER Physician Group

  • Emergency Medicine Physician
  • Perryton, TX
National Provider Identifier
1043362908
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D1548 Issued in TX
Legal business name
OCHILTREE HOSPITAL DISTRICT
Doing business as
Ochiltree General Hospital ER Physician Group
Practice address
3101 Garrett Drive
Perryton, TX 79070-5323
Phone
(806) 435-3606
Fax
(806) 435-2813
NPI assigned
Jan 18, 2007
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Mrs. Kelly Paige Judice
Title
Interim Ceo
Phone
(806) 435-3606

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Emergency Medicine Physician 207P00000X G2576 TX
Emergency Medicine Physician 207P00000X G3581 TX
Emergency Medicine Physician 207P00000X G4911 TX
Emergency Medicine Physician 207P00000X L9981 TX
Emergency Medicine Physician 207P00000X E8078 TX
Emergency Medicine Physician 207P00000X D1548 TX Primary

Addresses

Primary practice location

3101 Garrett Drive
Perryton, TX 79070-5323

Mailing address

3101 Garrett Drive
Perryton, TX 79070-5323
Phone (806) 435-3606

Other identifiers 1

IdentifierTypeStateIssuer
121902403MedicaidTX

Other names 1

  • Ochiltree General Hospital ER Physician Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910000841 TX Part B Supplier - Clinic/Group Practice 0749257723 Receives reassigned benefits from 72 practitioners
3 other NPIs on this enrollment
Practice locations: Perryton, TX

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ochiltree General HospitalPerryton, TX, CCN 451359 Hospital Operational/Managerial Control Jul 15, 2010
Ochiltree General HospitalPerryton, TX, CCN 45Z359 Hospital Operational/Managerial Control Jan 1, 2011
Ochiltree Hospital DistrictPerryton, TX, CCN 457640 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2009
Hospice of Ochiltree General HospitalPerryton, TX, CCN 451589 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 18, 2013
Nov 18, 2013
Perryton Health CenterPerryton, TX, CCN 458750 Rural health clinic Operational/Managerial Control May 6, 2010

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 72

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.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1043362908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 GARRETT DRIVE",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790705323",
            "telephone_number": "806-435-3606",
            "fax_number": "806-435-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 GARRETT DRIVE",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790705323",
            "telephone_number": "806-435-3606",
            "fax_number": "806-435-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHILTREE HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "JUDICE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "806-435-3606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G2576",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G3581",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G4911",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L9981",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "E8078",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "D1548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121902403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ochiltree General Hospital ER Physician Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ochiltree General Hospital ER Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perryton, TX

Sources for this page

Verify at the official NPI Registry.