Organization Active NPI

Cornerstone Family Medicine, PLLC

  • Rural Health Clinic/Center
  • Comanche, TX
National Provider Identifier
1124557319
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CORNERSTONE FAMILY MEDICINE, PLLC
Practice address
408 N Austin St
Comanche, TX 76442-2408
Phone
(817) 925-0046
NPI assigned
Jun 9, 2017
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
Dr. Molly Brooks Gray, DONPI 1760641187
Title
Owner Physician
Phone
(325) 356-1135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

408 N Austin St
Comanche, TX 76442-2408

Mailing address

408 N Austin St
Comanche, TX 76442-2408
Phone (325) 356-1135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

408 N Austin St
Comanche, TX 76442
Phone (325) 356-1135

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25194/brand/1/csg/1/fhir/r4

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jul 28, 2023 Change of OwnershipThis provider was the seller Corner Stone Family MedicineCCN 678567, TX, NPI 1659054005

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1124557319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N AUSTIN ST",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764422408",
            "telephone_number": "325-356-1135",
            "fax_number": "325-356-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N AUSTIN ST",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764422408",
            "telephone_number": "817-925-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "325-356-1135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comanche, TX

Sources for this page

Verify at the official NPI Registry.