Active NPI
Jon Sampson Hitchcock, DO
- Emergency Medicine Physician
- Porter, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- R3102
- Practice address
- 3339 Ashberry Falls LN
Porter, TX 77365-6689 - Phone
- (931) 212-4412
- NPI assigned
- Jul 9, 2015
- Last updated
- Sep 17, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | R0089 | OK | |
| Emergency Medicine Physician | 207P00000X | R3102 | TX | Primary |
Addresses
Primary practice location
3339 Ashberry Falls LN
Porter, TX 77365-6689
Mailing address
3339 Ashberry Falls LN
Porter, TX 77365-6689
Phone (931) 212-4412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400512603 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Lincoln Memorial University Medical Department, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16100 S Fwy
Pearland, TX 77584-1895
Phone (713) 338-6565
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5995 | OK | MD | General Practice Dentistry |
| R0089 | OK | MD | Emergency Medicine Physician |
| R3102 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hermann Hospital Based Physician Group | Emergency Medicine | Current | Accepting new patients |
| Acs Primary Care Physicians Southwest, PA | Emergency Medicine | Current | Accepting new patients |
| Memorial Hermann Health System | Past | Accepting new patients |
Locations
27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000
921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439
2555 Gulf Fwy S
League City, TX 77573
Phone (832) 932-9850
2555 Gulf Fwy S
#C1100
League City, TX 77573
2555 Gulf Fwy S
Ste C1100
League City, TX 77573
Phone (832) 932-9850
2901 4th St
Longview, TX 75605
Phone (281) 371-1800
11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100
16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000
9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300
9250 Pinecroft Dr
#C
Shenandoah, TX 77380
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Houston, TX
- NPI 1295363497
-
- Emergency Medicine Physician
- Gainesville, TX
- NPI 1538101019
-
dba Memorial Hermann Pharmacy-TMC
- Community/Retail Pharmacy
- Houston, TX
- NPI 1366229619
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MHHS NW Radiation Therapy
- Radiology Clinic/Center
- Houston, TX
- NPI 1013948553
Hospital
-
dba MHHS Woodlands Outpatient Imaging System
- Radiology Clinic/Center
- The Woodlands, TX
- NPI 1275564858
Hospital
-
dba Memorial Hermann Outpatient Imaging-Southwest
- Radiology Clinic/Center
- Houston, TX
- NPI 1407959448
Hospital
-
dba MHHS Friendswood Imaging
- Radiology Clinic/Center
- Friendswood, TX
- NPI 1508896267
Hospital
-
dba MHHS Pearland Outpatient Imaging Center
- Radiology Clinic/Center
- Pearland, TX
- NPI 1669402335
Hospital
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1134502008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3339 ASHBERRY FALLS LN",
"city": "PORTER",
"state": "TX",
"postal_code": "773656689",
"telephone_number": "931-212-4412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3339 ASHBERRY FALLS LN",
"city": "PORTER",
"state": "TX",
"postal_code": "773656689",
"telephone_number": "931-212-4412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HITCHCOCK",
"first_name": "JON",
"middle_name": "SAMPSON",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-09",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OK",
"license": "R0089",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "R3102",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "400512603",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Porter, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.