NPIMap

Organization Active NPI

Jordan's Place Pediatrics, PA

  • Primary Care Clinic/Center
  • Sulphur Springs, TX
National Provider Identifier
1245419431
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
K7145 Issued in TX
Legal business name
JORDAN'S PLACE PEDIATRICS, PA
Doing business as
Jordan's Place Pediatrics, PA
Practice address
1317 N Hillcrest Dr
Sulphur Springs, TX 75482-2091
Phone
(903) 438-1110
Fax
(903) 438-1107
NPI assigned
Oct 24, 2007
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Dr. Sherri Stone Barclay, M.D.NPI 1154381259
Title
Physican
Phone
(903) 438-1110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X K7145 TX Primary

Addresses

Primary practice location

1317 N Hillcrest Dr
Sulphur Springs, TX 75482-2091

Mailing address

1317 N Hillcrest Dr
Sulphur Springs, TX 75482-2091
Phone (903) 438-1110

Other identifiers 5

IdentifierTypeStateIssuer
0069GWOtherTXBCBS GROUP
150000102MedicaidTX
150000101MedicaidTX
8C0310OtherTXBCBS INDVL
1154381259OtherTXNPI INDVL

Other names 1

  • Jordan's Place Pediatrics, PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jordans Place Pediatrics PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

984 N Texas St
Emory, TX 75440
Phone (903) 438-0433

Practitioners & affiliated clinicians

Practitioners 8

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": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1245419431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN'S PLACE PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "STONE",
        "authorized_official_title_or_position": "PHYSICAN",
        "authorized_official_telephone_number": "903-438-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "K7145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0069GW",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150000102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150000101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDVL",
            "identifier": "8C0310",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDVL",
            "identifier": "1154381259",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan's Place Pediatrics, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sulphur Springs, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.