NPIMap

Organization Active NPI

Cardinal Community Clinic

  • Professional Counselor
  • Beaumont, TX
National Provider Identifier
1073904702
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CARDINAL COMMUNITY CLINIC
Practice address
4400 MLK Boulevard
Beaumont, TX 77710-0000
Phone
(409) 880-7681
Fax
(409) 880-2263
NPI assigned
Feb 17, 2015
Organization subpart
Yes
Parent organization
LAMAR UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Authorized official

Name
Dr. Carl Sheperis
Title
Department Chair
Phone
(409) 880-8978

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

4400 MLK Boulevard
Beaumont, TX 77710-0000

Mailing address

4400 MLK Boulevard
PO 10034
Beaumont, TX 77710-0000
Phone (409) 880-7681

National Provider Directory

National Provider Directory
Tax ID family
Lamar University4 organizations share this tax ID, including this one
Part of
Lamar University

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1073904702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 MLK BOULEVARD",
            "address_2": "PO 10034",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777100000",
            "telephone_number": "409-880-7681",
            "fax_number": "409-880-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 MLK BOULEVARD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777100000",
            "telephone_number": "409-880-7681",
            "fax_number": "409-880-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL COMMUNITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAMAR UNIVERSITY",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "SHEPERIS",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "409-880-8978",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.