East Texas Management, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

012132 Issued in TX

Legal business name

EAST TEXAS MANAGEMENT, LLC

Doing business as

East Texas Home Health

Practice address

708 Southview Circle
Center, TX 75935

Phone

(936) 591-9550

Fax

(936) 591-9543

NPI assigned

May 9, 2006

Last updated

Nov 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krista M Jernigan

Title

Administrator/Owner

Phone

(936) 969-2103

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• East Texas Home Health Doing business as

Locations

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1114976925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14046 MAIN STREET",
            "city": "CHESTER",
            "state": "TX",
            "postal_code": "75936",
            "telephone_number": "936-969-2103",
            "fax_number": "936-969-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 SOUTHVIEW CIRCLE",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "75935",
            "telephone_number": "936-591-9550",
            "fax_number": "936-591-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "936-969-2103"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "007653",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "012132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146621101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147979202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• East Texas Medical Clinic,P.a

• Home Health Agency in Center, TX
• Providers in Center, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.