Organization Active NPI

Groveton Texas Hospital Authority

  • Nursing Facility/Intermediate Care Facility
  • Groveton, TX
National Provider Identifier
1376602607
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
GROVETON TEXAS HOSPITAL AUTHORITY
Practice address
1020 W 1St St
Groveton, TX 75845
Phone
(936) 642-1221
Fax
(936) 642-2727
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Authorized official

Name
Jennifer Lynn Cleveland, MBA
Title
Business Office Manager
Phone
(936) 642-1221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

1020 W 1St St
Groveton, TX 75845

Mailing address

PO Box 890
Groveton, TX 75845-0890
Phone (936) 642-1221

Other identifiers 1

IdentifierTypeStateIssuer
000477801MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1376602607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "GROVETON",
            "state": "TX",
            "postal_code": "758450890",
            "telephone_number": "936-642-1221",
            "fax_number": "936-642-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W 1ST ST",
            "city": "GROVETON",
            "state": "TX",
            "postal_code": "75845",
            "telephone_number": "936-642-1221",
            "fax_number": "936-642-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVETON TEXAS HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "936-642-1221",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000477801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.