NPIMap

Organization Active NPI

Starks Medical

  • Primary Care Nurse Practitioner
  • Bullard, TX
National Provider Identifier
1306570593
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
STARKS MEDICAL
Practice address
125 E Main St
Bullard, TX 75757-5345
Phone
(903) 339-0887
NPI assigned
Jul 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Authorized official

Name
Lindsey Waldrop
Title
Billing Manager
Phone
(903) 339-0887

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

125 E Main St
Bullard, TX 75757-5345

Mailing address

125 E Main St
Bullard, TX 75757-5345
Phone (903) 339-0887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220920000053 TX Part B Supplier - Clinic/Group Practice 2567847015 Receives reassigned benefits from 5 practitioners
Practice locations: Bullard, TX

National Provider Directory

National Provider Directory

Locations

709 S Houston St
Bullard, TX 75757
Phone (903) 339-0887

125 E Main St
Bullard, TX 75757
Phone (903) 339-0887

Practitioners & affiliated clinicians

Practitioners 214

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

View all 214

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727568000000",
    "number": "1306570593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E MAIN ST",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575345",
            "telephone_number": "903-339-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E MAIN ST",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575345",
            "telephone_number": "903-339-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKS MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A",
        "authorized_official_last_name": "WALDROP",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "903-339-0887"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullard, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.