NPIMap

Organization Active NPI

Dimmit Regional Hospital

  • Emergency Medicine Physician
  • Carrizo Springs, TX
National Provider Identifier
1164774253
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
100064 Issued in TX
Legal business name
DIMMIT REGIONAL HOSPITAL
Practice address
704 Hospital Dr
Carrizo Springs, TX 78834-3836
Phone
(830) 876-2424
Fax
(830) 876-9126
NPI assigned
Oct 12, 2012
Last updated
Oct 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Mr. Ernest Flores Jr.
Title
Ceo
Phone
(830) 876-2424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 100064 TX Primary

Addresses

Primary practice location

704 Hospital Dr
Carrizo Springs, TX 78834-3836

Mailing address

PO Box 1016
Carrizo Springs, TX 78834-7016
Phone (830) 876-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121129000364 TX Part B Supplier - Clinic/Group Practice 0446385496 Receives reassigned benefits from 64 practitioners
4 other NPIs on this enrollment
Practice locations: Carrizo Springs, TX; Crystal City, TX

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.

National Provider Directory

National Provider Directory
Tax ID family
Dimmit Regional Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/bfa557fc-696e-49f4-8d78-7cdfe1e82721/
  • FHIR API: https://fhir-usa.unify.chbase.com/org/dimmit-a3ff579f

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dimmit Regional HospitalCarrizo Springs, TX, CCN 451390 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2017
Jan 1, 2017
Dimmit Regional HospitalCarrizo Springs, TX, CCN 45Z390 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2017
Jan 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 64

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 64

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1164774253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1016",
            "city": "CARRIZO SPRINGS",
            "state": "TX",
            "postal_code": "788347016",
            "telephone_number": "830-876-2424",
            "fax_number": "830-876-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 HOSPITAL DR",
            "city": "CARRIZO SPRINGS",
            "state": "TX",
            "postal_code": "788343836",
            "telephone_number": "830-876-2424",
            "fax_number": "830-876-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMMIT REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "830-876-2424",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "100064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrizo Springs, TX

Sources for this page

Verify at the official NPI Registry.