NPIMap

Organization Active NPI

Fannin County Hospital Authority

Doing business as Red River Family Practice

  • Family Medicine Physician
  • Bonham, TX
National Provider Identifier
1184047599
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FANNIN COUNTY HOSPITAL AUTHORITY
Doing business as
Red River Family Practice
Practice address
2105 N Center St
Bonham, TX 75418-2627
Phone
(903) 449-4698
NPI assigned
Jan 22, 2014
Last updated
Jan 22, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
FANNIN COUNTY HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Jay J Hodges
Title
Cfo
Phone
(903) 640-7311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2105 N Center St
Bonham, TX 75418-2627

Mailing address

PO Box C
Bonham, TX 75418-0180
Phone (903) 640-7311

Other names 1

  • Red River Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130923000100 TX Part B Supplier - Clinic/Group Practice 6002054764 Receives reassigned benefits from 4 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bonham, TX; Van Alstyne, TX

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Fannin Cnty Hosp Authority

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1184047599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754180180",
            "telephone_number": "903-640-7311",
            "fax_number": "903-640-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 N CENTER ST",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754182627",
            "telephone_number": "903-449-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANNIN COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FANNIN COUNTY HOSPITAL AUTHORITY",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-640-7311"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red River Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.