NPIMap

Organization Active NPI

Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
National Provider Identifier
1124092036
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
CHRISTUS GOOD SHEPHERD MEDICAL CENTER
Practice address
700 E Marshall Ave
Longview, TX 75601-5580
Phone
(903) 315-2000
NPI assigned
Feb 15, 2006
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTUS HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Norman Todd Hancock
Title
Ceo
Phone
(903) 315-4000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Rehabilitation Hospital Unit 273Y00000X TX
General Acute Care Hospital 282N00000X TX Primary

Addresses

Primary practice location

700 E Marshall Ave
Longview, TX 75601-5580

Mailing address

PO Box 732041
Dallas, TX 75373-2041
Phone (903) 315-2000

Other practice location 1

811 S Washington Ave
Marshall, TX 75670-5336
Phone (903) 927-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040604000400 TX Part B Supplier - Clinic/Group Practice 3779565544 Receives reassigned benefits from 106 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marshall, TX; Longview, TX; Kilgore, TX
O20090116000241 TX Part A Provider - Hospital 3779565544
O20090120000342 TX Part A Provider - Hospital 3779565544 Practice locations: Marshall, TX; Longview, TX

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1124092036. Details of each certification follow.

Hospital certification: CCN 450032

Legal name
CHRISTUS GOOD SHEPHERD MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 18, 2025
Beds
574 (456 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Sep 1, 2017 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1954 in TX
Enrollment address
700 E Marshall Ave
Longview, TX 75601-5580
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 45T032

Legal name
CHRISTUS GOOD SHEPHERD MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Mar 23, 1954 in TX
Enrollment address
700 E Marshall Ave
Longview, TX 75601-5580
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Hospital certification: CCN 450037

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHRISTUS GOOD SHEPHERD MEDICAL CENTER- LONGVIEW
Certification status
Terminated Voluntary: merger or closure, Sep 1, 2017
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 15, 2016
Beds
425 (350 certified)
Ownership / control type
Private (not for profit)
Facility address
700 East Marshall Avenue
Longview, TX 75601

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Christus Good Shepherd Medical CenterCCN 450032 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Christus Good Shepherd Medical Center - LongviewCCN 45T032 · All quality measures
Ownership
Non-profit
Certified
Sep 27, 2000

National Provider Directory

National Provider Directory
Part of
Christus Health

Locations

1875 US Highway 259 S
Henderson, TX 75654
Phone (903) 315-2074

1614 S Henderson Blvd
Ste B
Kilgore, TX 75662
Phone (903) 606-3160

2220 H G Mosley Pkwy
Longview, TX 75604
Phone (903) 247-3422

323 E Hawkins Pkwy
Ste D
Longview, TX 75605
Phone (903) 315-4450

323 E Hawkins Pkwy
Ste E
Longview, TX 75605
Phone (903) 544-6700

701 E Marshall Ave
Ste 100
Longview, TX 75601
Phone (903) 315-2715

701 E Marshall Ave
Ste 104
Longview, TX 75601
Phone (903) 315-2755

701 E Marshall Ave
Ste 106
Longview, TX 75601
Phone (903) 315-2758

703 E Marshall Ave
Ste 1001
Longview, TX 75601
Phone (903) 753-7291

703 E Marshall Ave
Ste 2000
Longview, TX 75601
Phone (903) 236-5300

703 E Marshall Ave
Ste 4008
Longview, TX 75601
Phone (903) 315-2729

705 E Marshall Ave
Ste 1003
Longview, TX 75601
Phone (903) 315-3860

705 E Marshall Ave
Ste 4001
Longview, TX 75601
Phone (903) 315-2366

612 S Grove St
Marshall, TX 75670
Phone (903) 927-6900

618 S Grove St
Ste 100
Marshall, TX 75670
Phone (903) 315-2504

618 S Grove St
Ste 200
Marshall, TX 75670
Phone (903) 934-5310

815 S Washington Ave
Ste 304
Marshall, TX 75670
Phone (903) 315-2032

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Christopher Glenney Individual Corporate DirectorBoard Member Jan 1, 2021
Christus Health Organization, Irving, TX Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Dec 7, 2017 100%
Christus Northeast Texas and Northern Louisiana Health System Corp Organization, Irving, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2021 100%
Shannon Dacus Individual Corporate DirectorBoard Member Jan 1, 2021
Rita Fanning Individual Corporate DirectorBoard Member Jan 21, 2021
Theresa M Popp Individual Corporate DirectorBoard Member Jan 1, 2022
Norman Todd Hancock Individual Corporate OfficerCeo Feb 1, 2017
W-2 Managing EmployeeCeo Feb 1, 2017
Jeb Jones Individual Corporate DirectorBoard Member Jan 21, 2021
Charles Michael Cheek Individual Corporate OfficerCfo Sep 1, 2017
Mark R Anderson Individual Corporate DirectorBoard Member Jan 1, 2021
Sonia Acosta Individual Corporate DirectorBoard Member Sep 16, 2024
Steven P Keuer Individual Corporate DirectorBoard Member Jan 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 49

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 49

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 161

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 161

Affiliated clinicians 785

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 785

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1124092036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732041",
            "telephone_number": "903-315-2000",
            "fax_number": "903-315-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "TX",
            "postal_code": "756705336",
            "country_code": "US",
            "telephone_number": "903-927-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTUS GOOD SHEPHERD MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTUS HEALTH",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-315-4000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.