Organization Active NPI

Bethany Home Health of Nacogdoches, Inc.

Doing business as Bethany Home Health Services

  • Home Health Agency
  • Nacogdoches, TX
National Provider Identifier
1093874455
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BETHANY HOME HEALTH OF NACOGDOCHES, INC.
Doing business as
Bethany Home Health Services
Practice address
4928 North St
Nacogdoches, TX 75965-1878
Phone
(936) 569-2949
Fax
(936) 569-6203
NPI assigned
Dec 8, 2006
Last updated
Sep 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Authorized official

Name
Bradley P LassiterNPI 1730553959
Title
Ceo
Phone
(972) 248-2441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4928 North St
Nacogdoches, TX 75965-1878

Mailing address

5000 Legacy Dr
Suite 360
Plano, TX 75024-3100
Phone (972) 248-2441

Other identifiers 1

IdentifierTypeStateIssuer
151627001MedicaidTX

Other names 1

  • Bethany Home Health Services Doing business as

National Provider Directory

National Provider Directory

Locations

409 Magrill St
Longview, TX 75601
Phone (903) 553-0056

4928 North St
Nacogdoches, TX 75965
Phone (877) 660-0749

411 Avenue A St
Palestine, TX 75801
Phone (903) 727-2016

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1093874455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LEGACY DR",
            "address_2": "SUITE 360",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243100",
            "telephone_number": "972-248-2441",
            "fax_number": "972-248-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651878",
            "telephone_number": "936-569-2949",
            "fax_number": "936-569-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY HOME HEALTH OF NACOGDOCHES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "LASSITER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-248-2441"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151627001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethany Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.