NPIMap

Organization Active NPI

Hendry County Hospital Authority

Doing business as Hendry Regional Wound Care and Hyperbaric Medicine

  • Medical Specialty Clinic/Center
  • Clewiston, FL
National Provider Identifier
1326335076
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
3995 Issued in FL
Legal business name
HENDRY COUNTY HOSPITAL AUTHORITY
Doing business as
Hendry Regional Wound Care and Hyperbaric Medicine
Practice address
542 W Sagamore Ave
Clewiston, FL 33440-3514
Phone
(863) 902-3052
Fax
(863) 983-6655
NPI assigned
Jul 1, 2011
Organization subpart
Yes
Parent organization
HENDRY REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Mr. Lynn W. Beasley, CEO
Title
Ceo
Phone
(863) 902-3076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 3995 FL Primary

Addresses

Primary practice location

542 W Sagamore Ave
Clewiston, FL 33440-3514

Mailing address

542 W Sagamore Ave
Clewiston, FL 33440-3514
Phone (863) 902-3052

Other names 1

  • HENDRY REGIONAL WOUND CARE AND HYPERBARIC MEDICINE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000106 FL Part B Supplier - Clinic/Group Practice 8022912435 Receives reassigned benefits from 33 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clewiston, FL; Labelle, FL

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Naaman Abdullah MD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JADFAD
  • FHIR API: https://fhir-usa.unify.chbase.com/org/hendry-ea4df457

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1326335076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 W SAGAMORE AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-902-3052",
            "fax_number": "863-983-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 W SAGAMORE AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-902-3052",
            "fax_number": "863-983-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRY COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENDRY REGIONAL MEDICAL CENTER",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-902-3076",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "3995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENDRY REGIONAL WOUND CARE AND HYPERBARIC MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clewiston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.