Organization Active NPI

Shannon Medical Center

  • Psychiatric Hospital Unit
  • San Angelo, TX
National Provider Identifier
1235199084
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
SHANNON MEDICAL CENTER
Practice address
2018 Pulliam St
San Angelo, TX 76905-5148
Phone
(325) 657-5031
NPI assigned
Mar 24, 2006
Last updated
Aug 26, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SHANNON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Miss Patricia Kirkham
Title
Billing Supervisor
Phone
(325) 657-5031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

2018 Pulliam St
San Angelo, TX 76905-5148

Mailing address

PO Box 1879
San Angelo, TX 76902-1879
Phone (325) 657-5031

Other identifiers 2

IdentifierTypeStateIssuer
137226006MedicaidTX
HH3102OtherTXBLUE CROSS PSYCH

National Provider Directory

National Provider Directory
Part of
Shannon Air Med 1

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1235199084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1879",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769021879",
            "telephone_number": "325-657-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 PULLIAM ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769055148",
            "telephone_number": "325-657-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHANNON MEDICAL CENTER",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "325-657-5031",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137226006",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PSYCH",
            "identifier": "HH3102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.