NPIMap

Organization Active NPI

Patrick D Reeves Mdpa

Doing business as Wilson Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
National Provider Identifier
1093895757
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
007928 Issued in TX
Legal business name
PATRICK D REEVES MDPA
Doing business as
Wilson Surgicenter
Practice address
4315 28TH Street
Suite 2
Lubbock, TX 79410
Phone
(806) 792-2104
Fax
(806) 792-2134
NPI assigned
Oct 17, 2006
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Mr. Patrick Darren Reeves, MDNPI 1942305883
Title
Owner
Phone
(806) 792-2104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 007928 TX Primary

Addresses

Primary practice location

4315 28TH Street
Suite 2
Lubbock, TX 79410

Mailing address

4315 28TH Street
Suite 2
Lubbock, TX 79410
Phone (806) 792-2104

Other identifiers 1

IdentifierTypeStateIssuer
159707201MedicaidTX

Other names 1

  • Wilson Surgicenter Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120224000306 TX Part B Supplier - Ambulatory Surgical Center 3971675711 Practice locations: Lubbock, TX

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Wilson SurgicenterCCN 45C0001033
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Patrick D Reeves Mdpa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4315 28th St
Ste 2
Lubbock, TX 79410
Phone (806) 792-2104

Interoperability endpoints

  • Direct secure messaging: janderson@wilsonsurg.intellechartdirect.net
  • Direct secure messaging: preeves@wilsonsurg.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 4

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1093895757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 28TH STREET",
            "address_2": "SUITE 2",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-792-2104",
            "fax_number": "806-792-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 28TH STREET",
            "address_2": "SUITE 2",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-792-2104",
            "fax_number": "806-792-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK D REEVES MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-792-2104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159707201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Surgicenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.