Individual provider Active NPI

Donald Green Culbertson, P.A.

  • Medical Physician Assistant
  • Marfa, TX
National Provider Identifier
1306949805
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02637 Issued in TX
Practice address
210 S Summer St,
Marfa, TX 79843-0267
Phone
(432) 729-1800
Fax
(432) 729-1806
NPI assigned
Sep 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA02637 TX Primary

Addresses

Primary practice location

210 S Summer St,
Marfa, TX 79843-0267

Mailing address

PO Box 267
Marfa, TX 79843-0267
Phone (432) 729-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070523000066 TX Practitioner - Physician Assistant 7315044575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marfa Country Clinic, P.a.Group PAC ID 2567590953, 6 clinicians

Practice addresses (Care Compare)

PO Box
Suite 368
Marfa, TX 79843

PO Box
Suite 368
Marfa, TX 79843-0368

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Preventative Care Health Services, Inc CurrentSince Aug 4, 2006 Accepting new patients
Marfa Country Clinic, P.a. CurrentSince Apr 19, 2010 Accepting new patients
Marfa Health & Wellness, Inc. Past Accepting new patients

Locations

1605 N State Highway 118
Alpine, TX 79830
Phone 4328374555206

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marfa Country Clinic, P.a.Marfa, TX, CCN 678946 Rural health clinic 5% Or Greater Direct Ownership Interest (49%)
Corporate Officer
Operational/Managerial Control
May 1, 2010
May 1, 2010
May 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306949805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267",
            "city": "MARFA",
            "state": "TX",
            "postal_code": "798430267",
            "telephone_number": "432-729-1800",
            "fax_number": "432-729-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S SUMMER ST,",
            "city": "MARFA",
            "state": "TX",
            "postal_code": "798430267",
            "telephone_number": "432-729-1800",
            "fax_number": "432-729-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "DONALD",
        "middle_name": "GREEN",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marfa, TX

Sources for this page

Verify at the official NPI Registry.