Good Shepherd Medical Center - Linden, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC

Doing business as

Good Shepherd Glenn-Garrett Clinic - Jefferson

Practice address

903 N Walcott St
Jefferson, TX 75657-1128

Phone

(903) 665-9500

Fax

(903) 665-9501

NPI assigned

May 3, 2006

Last updated

Jul 26, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

GOOD SHEPHERD MEDICAL CENTER - LINDEN, INCAs reported in NPPES

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

Authorized official

Name

Mr. Ed D Banos

Title

President

Phone

(903) 315-1811

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Good Shepherd Glenn-Garrett Clinic - Jefferson Doing business as

Part of

Good Shepherd Medical Center - Linden Inc

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.

• Donald Rae Simmons, MD

  • Family Medicine Physician
  • Muenster, TX
  • NPI 1578556601
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1114985876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N KAUFMAN ST",
            "city": "LINDEN",
            "state": "TX",
            "postal_code": "755635234",
            "telephone_number": "903-756-5581",
            "fax_number": "903-756-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 N WALCOTT ST",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571128",
            "telephone_number": "903-665-9500",
            "fax_number": "903-665-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "BANOS",
        "authorized_official_first_name": "ED",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-315-1811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130943706",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR",
            "identifier": "127650",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF TEXAS",
            "identifier": "00H878",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP3371",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0504760001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Glenn-Garrett Clinic - Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robin Lynne Gale, PNP
• Maria Alicia Gauna
• Kimberly George
• Rebecca Gillean
• Marisa Lyon Glosson
• Debra Kay Goth
• Veronica Roshay Green
• Lorian Greene
• Bobby James Guichet Jr., BSN, RN
• Dana M Haden, R.PH.

• Rural Health Clinic/Center in Jefferson, TX
• Providers in Jefferson, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.