Winnie Community Hospital, L.L.C.
Organization Active NPI Primary Care Nurse Practitioner · Vidor, TX
NPI 1376937003 · NPPES record last updated Sep 4, 2026
Key facts
- NPI
- 1376937003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- AP1208950 (TX)
- Legal business name
- WINNIE COMMUNITY HOSPITAL, L.L.C.
- Practice address
- 20925 Ih 10
Vidor, TX 77662-2557 - Phone
- (409) 769-2295
- Fax
- (409) 769-3373
- NPI assigned
- Mar 19, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- WINNIE COMMUNITY HOSPITAL LLC
Authorized official
- Name
- Mr. Muhammad Tahir Javed
- Title
- Ceo
- Phone
- (409) 840-9601
Other NPIs on the same Medicare enrollment 5
Practitioners 29
-
Leonidas S Andres, M.D.
-
Zagum A Bhatti, M.D.
-
Mathew Cherian, MSN, AG-ACNP
-
Chelsi Renee Clayton, FNP
-
Jennifer Lee East, FNP
-
Kevin Wayne Farris, M.D
-
Amy Featherston, NP
-
Robert C. Hood, M.D.,F.R.C.P.C.
-
Momin Islam, MD
-
Katherine E Landor, FNP-BC
-
Brent Lee Mainwaring, M.D.
-
Ryan C McHugh, M.D.
-
Suzanne M Moree, RN-BSN, MSN, ACNP-BC
-
Benjamin Scott Odom, LPC/APRN
-
Mohsin Qayyum, M.D.
-
Robert O Rollo, MD
-
Maria Guadalupe Sanchez, PA-C
-
Alicia D Scoggins, FNCP
-
Morteza Shatery, MD
-
Simone Olivier Stewart, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2136167 | Riceland Clinic Vidor | Certificate of waiver | Sep 4, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031218000349 | TX | Part B Supplier - Clinic/Group Practice | 3375440894 |
Receives reassigned benefits from 31 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Winnie, TX; Vidor, TX; Silsbee, TX; Port Arthur, TX; Nederland, TX; Beaumont, TX |
National Provider Directory
- Part of
- Winnie Community Hospital LLC
Locations
3405 College St
Beaumont, TX 77701
Phone (409) 832-2211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Physician Assistant |
363A00000X | PA00871 | TX | |
| Nurse Practitioner |
363L00000X | |||
| Family Nurse Practitioner |
363LF0000X | |||
| Primary Care Nurse Practitioner |
363LP2300X | AP1208950 | TX | Yes |
Addresses
Primary practice location
20925 Ih 10
Vidor, TX 77662-2557
Mailing address
538 Broadway
Winnie, TX 77665-7600
Phone (409) 296-6000
Other practice location 1
2400 Highway 365 Ste 112
Nederland, TX 77627-6268
Phone (409) 724-7900
Other practice location 2
2162 Texas Ave
Bridge City, TX 77611-2838
Phone (409) 767-7034
Other practice location 3
85 Ih 10 N Ste 112
Beaumont, TX 77707-2560
Phone (409) 239-5139
Other practice location 4
520 S Twin City Hwy Ste 102
Nederland, TX 77627-4246
Phone (409) 723-0420
Other practice location 5
2400 Highway 365 Ste 109
Nederland, TX 77627-6268
Phone (409) 237-2800
Other practice location 6
711 Highway 327 E
Silsbee, TX 77656-5005
Phone (409) 373-9160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E7808 | Other | TX | MEDICAL LICENSE |
Other names
- Riceland Clinic
- Riceland Endocrinology Clinic
- Riceland Family Practice
Other providers in Vidor, TX
- Wal-Mart Stores Texas LLC
- Stephanie Brooke Waldrep
- Walgreen Co
- Walgreens
- Brandy Lea Whisenant
- Crystal Young
All providers in Vidor, TX · Primary Care Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.