Organization Active NPI

Stripling Clinic

  • Family Medicine Physician
  • Jacksonville, TX
National Provider Identifier
1073598496
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D9115 Issued in TX
Legal business name
STRIPLING CLINIC
Practice address
555 S Jackson St
Jacksonville, TX 75766-2476
Phone
(903) 586-2278
Fax
(903) 586-3127
NPI assigned
Dec 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Joe Randolph Danel, MD
Title
Owner
Phone
(903) 586-2278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D9115 TX Primary

Addresses

Primary practice location

555 S Jackson St
Jacksonville, TX 75766-2476

Mailing address

555 S Jackson St
Jacksonville, TX 75766-2476
Phone (903) 586-2278

Other identifiers 1

IdentifierTypeStateIssuer
034812001MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1073598496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662476",
            "telephone_number": "903-586-2278",
            "fax_number": "903-586-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662476",
            "telephone_number": "903-586-2278",
            "fax_number": "903-586-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRIPLING CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "DANEL",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-586-2278",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D9115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034812001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.