NPIMap

Organization Active NPI

Texarkana Regional Healthcare Network

  • Specialist
  • Texarkana, TX
National Provider Identifier
1083858831
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TEXARKANA REGIONAL HEALTHCARE NETWORK
Practice address
1000 Pine St
Texarkana, TX 75501-5100
Phone
(903) 798-7317
Fax
(903) 798-7377
NPI assigned
Apr 23, 2009
Last updated
May 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Jonathan A Demke
Title
Ceo
Phone
(615) 467-1072

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

1000 Pine St
Texarkana, TX 75501-5100

Mailing address

PO Box 847045
Dallas, TX 75284-7045
Phone (866) 724-6662

Other identifiers 2

IdentifierTypeStateIssuer
207889101MedicaidTX
196542002MedicaidAR

National Provider Directory

National Provider Directory

Locations

1307 Trinity Blvd
Texarkana, AR 71854
Phone (870) 773-6467

1002 Texas Blvd
Ste 325
Texarkana, TX 75501
Phone (903) 794-6544

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1083858831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847045",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847045",
            "telephone_number": "866-724-6662",
            "fax_number": "314-432-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE ST",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015100",
            "telephone_number": "903-798-7317",
            "fax_number": "903-798-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA REGIONAL HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "DEMKE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-467-1072"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207889101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196542002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.