NPIMap

Organization Active NPI

Comanche County Medical Center Dba Doctors Medical Center

  • Family Medicine Physician
  • Comanche, TX
National Provider Identifier
1083851513
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMANCHE COUNTY MEDICAL CENTER DBA DOCTORS MEDICAL CENTER
Practice address
10201 Hwy 16 N
Comanche, TX 76442
Phone
(254) 879-4910
Fax
(254) 879-4991
NPI assigned
Jan 21, 2009
Last updated
Jan 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Jeanette Luckie
Title
Office Manager
Phone
(254) 879-4910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

10201 Hwy 16 N
Comanche, TX 76442

Mailing address

10201 Hwy 16 N
Comanche, TX 76442
Phone (254) 879-4910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083851513. Details of each certification follow.

Hospital certification: CCN 450234

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMANCHE COUNTY MEDICAL CENTER
Certification status
Terminated Other: provider status change, Mar 31, 2012
Provider type (POS)
Hospital – Short-term
Participating since
Oct 4, 1977
Last certification
Feb 1, 2012
Beds
38
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 2011 (2 total)
Facility address
10201 Hwy 16
Comanche, TX 76442

National Provider Directory

National Provider Directory
Tax ID family
Comanche Cty Cons Hosp Dist13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1083851513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 HWY 16 N",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "76442",
            "telephone_number": "254-879-4910",
            "fax_number": "254-879-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 HWY 16 N",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "76442",
            "telephone_number": "254-879-4910",
            "fax_number": "254-879-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY MEDICAL CENTER DBA DOCTORS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "LUCKIE",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "254-879-4910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comanche, TX

Sources for this page

Verify at the official NPI Registry.