NPIMap

Organization Active NPI

Comanche County Medical Center Company

Doing business as Comanche County Medical Center Emergency Room Group

  • Emergency Medicine Physician
  • Comanche, TX
National Provider Identifier
1184695231
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
412048192 Issued in TX
Legal business name
COMANCHE COUNTY MEDICAL CENTER COMPANY
Doing business as
Comanche County Medical Center Emergency Room Group
Practice address
10201 Highway 16
Comanche, TX 76442-4462
Phone
(254) 879-4900
Fax
(254) 879-4990
NPI assigned
Jan 27, 2006
Last updated
Apr 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Kevin Storey
Title
Ceo
Phone
(254) 879-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 412048192 TX Primary

Addresses

Primary practice location

10201 Highway 16
Comanche, TX 76442-4462

Mailing address

10201 Highway 16
Comanche, TX 76442-4462
Phone (254) 879-4900

Other identifiers 3

IdentifierTypeStateIssuer
121784605MedicaidTX
00291VOtherTXER PHYS GROUP
00L94GOtherTXBCBS OF TX-ER PHYS GROUP

Other names 1

  • Comanche County Medical Center Emergency Room Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comanche Cty Cons Hosp Dist13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

407 S Texas St
De Leon, TX 76444
Phone (254) 893-2011

Practitioners & affiliated clinicians

Practitioners 7

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": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1184695231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4900",
            "fax_number": "254-879-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4900",
            "fax_number": "254-879-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY MEDICAL CENTER COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "STOREY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "254-879-4900"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "412048192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121784605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ER PHYS GROUP",
            "identifier": "00291V",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX-ER PHYS GROUP",
            "identifier": "00L94G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comanche County Medical Center Emergency Room Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Comanche, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.