NPIMap

Organization Active NPI

Stamford Hospital District

  • Assisted Living Facility
  • Stamford, TX
National Provider Identifier
1124302955
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
132325 Issued in TX
Legal business name
STAMFORD HOSPITAL DISTRICT
Practice address
1700 Columbia St
Stamford, TX 79553
Phone
(325) 773-5511
Fax
(325) 773-5522
NPI assigned
Sep 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Authorized official

Name
William R Lee
Title
Manager
Phone
(325) 773-4805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 132325 TX Primary

Addresses

Primary practice location

1700 Columbia St
Stamford, TX 79553

Mailing address

1601 Columbia St
Stamford, TX 79553-6863
Phone (325) 773-4805

Other identifiers 1

IdentifierTypeStateIssuer
001025545MedicaidTX

Other names 1

  • Country Elegance Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cheryl a Kelley MD2 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.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1124302955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 COLUMBIA ST",
            "city": "STAMFORD",
            "state": "TX",
            "postal_code": "795536863",
            "telephone_number": "325-773-4805",
            "fax_number": "325-773-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COLUMBIA ST",
            "city": "STAMFORD",
            "state": "TX",
            "postal_code": "79553",
            "telephone_number": "325-773-5511",
            "fax_number": "325-773-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "325-773-4805"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "132325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025545",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Elegance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Country Elegance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stamford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.