NPIMap

Organization Active NPI

San Angelo Hospital LP

  • General Acute Care Hospital
  • San Angelo, TX
National Provider Identifier
1194776104
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000056 Issued in TX
Legal business name
SAN ANGELO HOSPITAL LP
Practice address
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone
(325) 949-9511
Fax
(325) 947-6550
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Paula Lalor
Title
Director/Delegated Official
Phone
(615) 925-4565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X
General Acute Care Hospital 282N00000X 000056 TX Primary

Addresses

Primary practice location

3501 Knickerbocker Rd
San Angelo, TX 76904-7610

Mailing address

PO Box 849051
Dallas, TX 75284-9051
Phone (325) 949-9511

Other identifiers 4

IdentifierTypeStateIssuer
121754904MedicaidTX
112693001MedicaidTX
112693002MedicaidTX
094719402MedicaidTX

Other names 1

  • San Angelo Community Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Hospital certification: CCN 450340

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SAN ANGELO COMMUNITY MEDICAL CENTER
Certification status
Terminated Voluntary: merger or closure, Oct 24, 2020
Provider type (POS)
Hospital – Short-term
Participating since
Jan 1, 1970
Last certification
Jul 14, 2017
Beds
171
Ownership / control type
Private (for profit)
Most recent change of ownership
Feb 1, 1999 (2 total)
Facility address
3501 Knickerbocker Road
San Angelo, TX 76904

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1194776104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849051",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752849051",
            "telephone_number": "325-949-9511",
            "fax_number": "325-947-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-949-9511",
            "fax_number": "325-947-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANGELO HOSPITAL LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121754904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112693001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112693002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094719402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Angelo Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.