Trinity Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

TRINITY CLINIC

Doing business as

Trinity Clinic Emory

Practice address

886 E Lennon Dr
Ste 105
Emory, TX 75440-3214

Phone

(903) 473-3036

Fax

(903) 473-2007

NPI assigned

Mar 19, 2007

Last updated

Apr 20, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

TRINITY CLINICAs reported in NPPES

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

Authorized official

Name

Mary Ann Harrison, CPC CMC

Title

Provider Enrollment Coordinator

Phone

(903) 510-1113

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Trinity Clinic Emory Doing business as

Tax ID family

Christus Trinity Clinic2 organizations share this tax ID, including this one

Part of

Tyler Radiologist

Other organizations with this tax ID 1

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

• Pca Primary Care Associates PA

  dba Pca Rehabilitation

  • Specialist
  • Greenville, TX
  • NPI 1902025778
  NPD tax ID

Locations

Practitioners 1

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.

• Mario A. Gutierrez, MD

  • Family Medicine Physician
  • Winnsboro, TX
  • NPI 1306897038
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1316061013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840698",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 E LENNON DR",
            "address_2": "STE 105",
            "city": "EMORY",
            "state": "TX",
            "postal_code": "754403214",
            "telephone_number": "903-473-3036",
            "fax_number": "903-473-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY CLINIC",
        "enumeration_date": "2007-03-19",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "903-510-1113",
        "authorized_official_credential": "CPC CMC"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177294904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184554701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137940601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP0098",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091888002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0030PS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Clinic Emory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Senior Suite Care and Rehab
• Charles Drew Smith
• Kassie Rhea Smith, MA, LBA, BCBA
• Texas Imaging LLC
• Trinity Clinic (Trinity Clinic Emory)
• Shana Michelle Turbyfill
• Bennett J. Vaculik, D.D.S.
• Walgreen Co (Walgreens #21462)
• Trina Weaver
• Korey James Young, D.C.

• Rural Health Clinic/Center in Emory, TX
• Providers in Emory, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.