NPIMap

Organization Active NPI

Falls Community Hospital and Clinic

Doing business as The Doctor Clinic

  • Emergency Medicine Physician
  • Marlin, TX
National Provider Identifier
1093743783
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J1957 Issued in TX
Legal business name
FALLS COMMUNITY HOSPITAL AND CLINIC
Doing business as
The Doctor Clinic
Practice address
322 Coleman St.
Marlin, TX 76660-0060
Phone
(254) 803-3561
Fax
(254) 883-6066
NPI assigned
Jun 29, 2006
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
FALLS COMMUNITY HOSPITAL AND CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Mr. Jeff Lyle
Title
Administrator
Phone
(254) 803-3561

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 24850 TX
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 8240 TX
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X J1957 TX Primary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X J0919 TX
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X E0892 TX
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X J5638 TX
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X D3139 TX
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X G1558 TX

Addresses

Primary practice location

322 Coleman St.
Marlin, TX 76660-0060

Mailing address

PO Box 60
Marlin, TX 76661-0060
Phone (254) 803-3561

Other practice location 1

307 Live Oak St
Marlin, TX 76661-2365
Phone (254) 803-3561

Other identifiers 2

IdentifierTypeStateIssuer
0815318-01MedicaidTX
00A27WOtherTXPTAN

Other names 1

  • The Doctor Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000971 TX Part B Supplier - Clinic/Group Practice 8527959816 Receives reassigned benefits from 43 practitioners
2 other NPIs on this enrollment
Practice locations: Marlin, TX

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Torbett-Hutchings Smi

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Falls Community Hospital and ClinicMarlin, TX, CCN 670780 Hospital 5% Or Greater Indirect Ownership Interest (20%) Apr 6, 2018
FCHC-Rosebud Medical ClinicRosebud, TX, CCN 458870 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2006

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1093743783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60",
            "city": "MARLIN",
            "state": "TX",
            "postal_code": "766610060",
            "telephone_number": "254-803-3561",
            "fax_number": "254-883-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 COLEMAN ST.",
            "city": "MARLIN",
            "state": "TX",
            "postal_code": "766600060",
            "telephone_number": "254-803-3561",
            "fax_number": "254-883-6066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Live Oak St",
            "address_purpose": "LOCATION",
            "city": "Marlin",
            "state": "TX",
            "postal_code": "766612365",
            "country_code": "US",
            "telephone_number": "254-803-3561",
            "fax_number": "254-883-6066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FALLS COMMUNITY HOSPITAL AND CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FALLS COMMUNITY HOSPITAL AND CLINIC",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "LYLE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "254-803-3561",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24850",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8240",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J1957",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J0919",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "E0892",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "J5638",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "D3139",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "G1558",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0815318-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "00A27W",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Doctor Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Doctor Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlin, TX

Sources for this page

Verify at the official NPI Registry.