NPIMap

Organization Active NPI

Suzanne M. Guynes, M.D.P.a.

  • Geriatric Psychiatry Physician
  • Weatherford, TX
National Provider Identifier
1063601466
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
H9968 Issued in TX
Legal business name
SUZANNE M. GUYNES, M.D.P.A.
Practice address
411 W Josephine St
Weatherford, TX 76086-5247
Phone
(817) 637-4358
Fax
(817) 594-5870
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Authorized official

Name
Lori Billman
Title
Claims Manager
Phone
(817) 470-6676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X H9968 TX Primary

Addresses

Primary practice location

411 W Josephine St
Weatherford, TX 76086-5247

Mailing address

PO Box 92878
Southlake, TX 76092-0878
Phone (817) 488-5308

Other identifiers 3

IdentifierTypeStateIssuer
081120001MedicaidTX
260045675OtherMEDICARE RAILROAD
00763NOtherTXBLUE CROSS BLUE SHIELD TEXAS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000119 TX Part B Supplier - Clinic/Group Practice 4789589276 Receives reassigned benefits from 5 practitioners
Practice locations: Weatherford, TX; Willow Park, TX; Azle, TX; Decatur, TX; Fort Worth, TX; Ft Worth, TX; Mineral Wells, TX

National Provider Directory

National Provider Directory

Locations

1000 McKinley St
Benbrook, TX 76126
Phone (817) 249-0020

115 E Lee Ave
Weatherford, TX 76086
Phone (817) 637-4358

1201 Holland Lake Dr
Weatherford, TX 76086
Phone (817) 598-0160

1101 Jameson St
Weatherford, TX 76086
Phone (817) 599-5075

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1063601466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92878",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920878",
            "telephone_number": "817-488-5308",
            "fax_number": "817-488-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W JOSEPHINE ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865247",
            "telephone_number": "817-637-4358",
            "fax_number": "817-594-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE M. GUYNES, M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "BILLMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CLAIMS  MANAGER",
        "authorized_official_telephone_number": "817-470-6676"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "TX",
            "license": "H9968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081120001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "260045675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TEXAS",
            "identifier": "00763N",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.