Organization Active NPI

Occumed Plus-Grand Prairie

  • General Practice Physician
  • Grand Prairie, TX
National Provider Identifier
1174962823
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OCCUMED PLUS-GRAND PRAIRIE
Practice address
805 W. North Carrier Pkwy
260
Grand Prairie, TX 75050
Phone
(817) 984-9580
Fax
(817) 984-9581
NPI assigned
Jun 17, 2013
Last updated
Jun 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Mrs. Sara Thomson, CMA/NCT
Title
Office Manager
Phone
(817) 984-9581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

805 W. North Carrier Pkwy
260
Grand Prairie, TX 75050

Mailing address

805 W. North Carrier Pkwy
260
Grand Prairie, TX 75050
Phone (817) 984-9580

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2110156Occumed Plus-Grand Prairie, LLC805 W Carrier Pkwy, Suite 260, Grand Prairie, TX 75050Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Occumed2 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.

Locations

805 W Carrier Pkwy
Ste 260
Grand Prairie, TX 75050
Phone (817) 984-9580

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": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1174962823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W. NORTH CARRIER PKWY",
            "address_2": "260",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75050",
            "telephone_number": "817-984-9580",
            "fax_number": "817-984-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W. NORTH CARRIER PKWY",
            "address_2": "260",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75050",
            "telephone_number": "817-984-9580",
            "fax_number": "817-984-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUMED PLUS-GRAND PRAIRIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "THOMSON",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-984-9581",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMA/NCT"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.