NPIMap

Organization Active NPI

East Texas Medical Center Mount Vernon

  • General Acute Care Hospital
  • Mount Vernon, TX
National Provider Identifier
1194807438
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000282 Issued in TX
Legal business name
EAST TEXAS MEDICAL CENTER MOUNT VERNON
Practice address
500 Hwy 37 S
Mount Vernon, TX 75457-6550
Phone
(903) 537-8000
Fax
(903) 537-8120
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Mr. William P Henderson
Title
Senior Administrator
Phone
(903) 537-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 000282 TX Primary

Addresses

Primary practice location

500 Hwy 37 S
Mount Vernon, TX 75457-6550

Mailing address

P O Box 477
500 South State Hwy 37
Mount Vernon, TX 75457-0477
Phone (903) 537-8000

Other identifiers 2

IdentifierTypeStateIssuer
00C52SOtherTXBLUE CROSS CRNA
136140405MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1194807438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 477",
            "address_2": "500 SOUTH STATE HWY 37",
            "city": "MOUNT VERNON",
            "state": "TX",
            "postal_code": "754570477",
            "telephone_number": "903-537-8000",
            "fax_number": "903-537-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HWY 37 S",
            "city": "MOUNT VERNON",
            "state": "TX",
            "postal_code": "754576550",
            "telephone_number": "903-537-8000",
            "fax_number": "903-537-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER MOUNT VERNON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SENIOR ADMINISTRATOR",
        "authorized_official_telephone_number": "903-537-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CRNA",
            "identifier": "00C52S",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136140405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.