Organization Active NPI

Northern Bay Womens Health Center, PA

  • Gynecology Physician
  • Plano, TX
National Provider Identifier
1295748168
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
NORTHERN BAY WOMENS HEALTH CENTER, PA
Practice address
6100 Windcom Court
Suite 102
Plano, TX 75093-7888
Phone
(459) 574-0111
Fax
(469) 574-0099
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Dr. Irwin Endelman, MD
Title
President
Phone
(469) 574-0111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X Primary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X

Addresses

Primary practice location

6100 Windcom Court
Suite 102
Plano, TX 75093-7888

Mailing address

6100 Windcom Court
Suite 102
Plano, TX 75093-7888
Phone (469) 574-0111

Other identifiers 1

IdentifierTypeStateIssuer
0808512901MedicaidTX

National Provider Directory

National Provider Directory

Locations

4325 N Josey Ln
Ste 100
Carrollton, TX 75010
Phone (469) 574-0111

6100 Windcom Ct
Ste 102
Plano, TX 75093
Phone (972) 964-0170

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1295748168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 WINDCOM COURT",
            "address_2": "SUITE 102",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937888",
            "telephone_number": "469-574-0111",
            "fax_number": "469-574-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 WINDCOM COURT",
            "address_2": "SUITE 102",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937888",
            "telephone_number": "459-574-0111",
            "fax_number": "469-574-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN BAY WOMENS HEALTH CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "ENDELMAN",
        "authorized_official_first_name": "IRWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-574-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0808512901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.