NPIMap

Organization Active NPI

Heb Emergicare PA

  • Emergency Medicine Physician
  • Bedford, TX
National Provider Identifier
1306812193
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
HEB EMERGICARE PA
Practice address
2700 Tibbets Dr
Suite #210
Bedford, TX 76022-5928
Phone
(817) 354-5600
NPI assigned
Feb 23, 2006
Last updated
Apr 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Authorized official

Name
Dan Peckenpaugh, MD
Title
President
Phone
(817) 685-4619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

2700 Tibbets Dr
Suite #210
Bedford, TX 76022-5928

Mailing address

P O Box 960046
Oklahoma City, OK 73196-0001
Phone (877) 485-4474

Other identifiers 5

IdentifierTypeStateIssuer
112655902MedicaidTX
112655904MedicaidTX
00L58LOtherTXBCBS
CQ3073OtherTXRAILROAD MEDICARE
1306812193OtherGROUP NPI

National Provider Directory

National Provider Directory

Locations

6031 W I 20
Ste 242C
Arlington, TX 76017

2700 Tibbets Dr
Ste 210
Bedford, TX 76022
Phone (817) 354-5600

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1306812193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 960046",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960001",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 TIBBETS DR",
            "address_2": "SUITE #210",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225928",
            "telephone_number": "817-354-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEB EMERGICARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "PECKENPAUGH",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-685-4619",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112655902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112655904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00L58L",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CQ3073",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1306812193",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.