NPIMap

Organization Active NPI

Metroplex Adventist Hospital, Inc

Doing business as Home Care of Metroplex Hospital

  • Home Health Agency
  • Killeen, TX
National Provider Identifier
1073990289
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
METROPLEX ADVENTIST HOSPITAL, INC
Doing business as
Home Care of Metroplex Hospital
Practice address
2115 S Clear Creek Rd
Killeen, TX 76549-4110
Phone
(254) 519-8930
Fax
(254) 526-0075
NPI assigned
Apr 27, 2015
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Mrs. Mamie L Lister, RN
Title
Administrator/Director
Phone
(254) 519-8930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X TX Primary

Addresses

Primary practice location

2115 S Clear Creek Rd
Killeen, TX 76549-4110

Mailing address

2115 S Clear Creek Rd
Killeen, TX 76549-4110
Phone (254) 519-8930

Other identifiers 10

IdentifierTypeStateIssuer
1316970569OtherNPI
N7148OtherHOMELINK
0005074210OtherAETNA
015OtherTRICARE
095172501MedicaidTX
132428100OtherFIRST CARE
236103100OtherUS DEPARTMENT OF LABOR WC
677733OtherHUMANA INSURANCE GOLD CHOICE MEDICARE
236103100OtherUS DOL/BLACK LUNG PROVIDER
677733OtherSTERLING LIFE MEDICARE

Other names 1

  • Home Care of Metroplex Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Metroplex Hospital ER8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2115 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8930

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1073990289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494110",
            "telephone_number": "254-519-8930",
            "fax_number": "254-526-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494110",
            "telephone_number": "254-519-8930",
            "fax_number": "254-526-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPLEX ADVENTIST HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "LISTER",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR/DIRECTOR",
        "authorized_official_telephone_number": "254-519-8930",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316970569",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOMELINK",
            "identifier": "N7148",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005074210",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "015",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095172501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "132428100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR WC",
            "identifier": "236103100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE GOLD CHOICE MEDICARE",
            "identifier": "677733",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL/BLACK LUNG PROVIDER",
            "identifier": "236103100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING LIFE MEDICARE",
            "identifier": "677733",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Care of Metroplex Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.