Ochiltree Hospital District
Organization Active NPI Emergency Medicine Physician · Perryton, TX
NPI 1043362908 · NPPES record last updated Oct 26, 2022
Key facts
- NPI
- 1043362908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- D1548 (TX)
- Legal business name
- OCHILTREE HOSPITAL DISTRICT
- Practice address
- 3101 Garrett Drive
Perryton, TX 79070-5323 - Phone
- (806) 435-3606
- Fax
- (806) 435-2813
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kelly Paige Judice
- Title
- Interim Ceo
- Phone
- (806) 435-3606
Owned or controlled facilities with NPI records 6
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 6
Member organizations 1
Practitioners 72
-
Jay Blasingame, MD
-
Susan White Childers, APRN
-
Deirdre Valois Floyd, RN, FNP-C
-
Alyce Ann Morton, FNP-C
-
Joshua Dale Stevenson, CRNA
-
David Ishimitsu, M.D.
-
Jeffrey A. Saunders, M.D.
-
Manon Childers, M.D.
-
Casey Don McGarraugh, PA-C
-
Lyudmyla Battin, FNP
-
Anita Marie Bertrand, CRNA
-
Megan M Blasingame, CRNA
-
Lisa Brown, FNP-C
-
Christian Joseph Ingui, M.D.
-
Suzanna Lynn Jarrell, FNP
-
Fah S Leong, MD
-
Rex L Mann, M.D.
-
Ricky Allen Siewert, D.O
-
David L Wells, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Ochiltree General Hospital |
Hospital | Operational/Managerial Control | Jul 15, 2010 |
| Ochiltree General Hospital |
Hospital | Operational/Managerial Control | Jan 1, 2011 |
| Ochiltree Hospital District |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2009 |
| Hospice of Ochiltree General Hospital |
Hospice | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 18, 2013 Nov 18, 2013 |
| Perryton Health Center |
Rural health clinic | Operational/Managerial Control | May 6, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | D1548 | TX | Yes |
| 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 | |
| Certified Registered Nurse Anesthetist |
367500000X |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121902403 | Medicaid | TX |
Other names
- Ochiltree General Hospital ER Physician Group
Other providers in Perryton, TX
- Ochiltree County Hospital District
- Ochiltree County Hospital District
- Ochiltree County Hospital District
- Ochiltree General Hospital
- Ochiltree Hospital District
- Ochiltree Hospital District
- Ochiltree Hospital District
- Ochiltree Hospital District
- Ochiltree Hospital District
- Ochiltree Hospital District
All providers in Perryton, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.