NPIMap

Organization Active NPI

Elliott-Thomas Health Center PC

  • Family Medicine Physician
  • Mineola, TX
National Provider Identifier
1134318215
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L1568 Issued in TX
Legal business name
ELLIOTT-THOMAS HEALTH CENTER PC
Practice address
415 W Kilpatrick St
Mineola, TX 75773-2032
Phone
(903) 569-2006
Fax
(903) 569-2206
NPI assigned
Oct 15, 2007
Last updated
Feb 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Authorized official

Name
Dr. Robert M Elliott, MDNPI 1750326799
Title
Physician
Phone
(903) 569-2006

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L1568 TX Primary

Addresses

Primary practice location

415 W Kilpatrick St
Mineola, TX 75773-2032

Mailing address

415 W Kilpatrick St
Mineola, TX 75773-2032
Phone (903) 569-2006

Other identifiers 5

IdentifierTypeStateIssuer
8H0920OtherTXBCBS
B74324OtherTXUPIN
00609UOtherTXMEDICARE PTAN
165700901MedicaidTX
110247094OtherTXRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18912/brand/1/csg/1/fhir/r4

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": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1134318215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W KILPATRICK ST",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732032",
            "telephone_number": "903-569-2006",
            "fax_number": "903-569-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W KILPATRICK ST",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732032",
            "telephone_number": "903-569-2006",
            "fax_number": "903-569-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT-THOMAS HEALTH CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "903-569-2006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H0920",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "B74324",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00609U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165700901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110247094",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.