NPIMap

Organization Active NPI

Mitchell County Hospital Distict

  • Skilled Nursing Facility
  • San Angelo, TX
National Provider Identifier
1265867709
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MITCHELL COUNTY HOSPITAL DISTICT
Practice address
609 Rio Concho Dr
San Angelo, TX 76903-6029
Phone
(325) 653-1266
Fax
(325) 655-6938
NPI assigned
Sep 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Robbie Dewberry
Title
Ceo
Phone
(325) 728-3431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

609 Rio Concho Dr
San Angelo, TX 76903-6029

Mailing address

609 Rio Concho Dr
San Angelo, TX 76903-6029
Phone (325) 653-1266

Other identifiers 1

IdentifierTypeStateIssuer
004815MedicaidTX

Other names 1

  • Arbor Terrace Health Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mitchell County Hospital11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1265867709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 RIO CONCHO DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036029",
            "telephone_number": "325-653-1266",
            "fax_number": "325-655-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 RIO CONCHO DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036029",
            "telephone_number": "325-653-1266",
            "fax_number": "325-655-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY HOSPITAL DISTICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "DEWBERRY",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-728-3431"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004815",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Terrace Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 3, 2013; 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.