Baylor Surgicare at Granbury LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130006 Issued in TX

Legal business name

BAYLOR SURGICARE AT GRANBURY LLC

Doing business as

Baylor Scott & White Surgicare-Granbury

Practice address

1717 Paluxy Rd
Granbury, TX 76048-5667

Phone

(817) 579-8863

Fax

(817) 579-8872

NPI assigned

Jan 26, 2009

Last updated

Oct 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donita Fleming

Title

Authorized Official

Phone

(202) 815-3665

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baylor Scott & White Surgicare-Granbury Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Baylor Surgicare at Granbury LLCCCN 45C0001471

Medicare certification status

ActiveFrom the Provider of Services file

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• Cross Timbers Orthopaedics

  dba Cross Timbers Orthopaedics & Sports Medicine

  • Medical Specialty Clinic/Center
  • Stephenville, TX
  • NPI 1699870808

  Member Of

  NPD member
• Premier Orthopedics of Fort Worth, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fort Worth, TX
  • NPI 1851652457

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1386882587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485667",
            "telephone_number": "817-579-8863",
            "fax_number": "817-579-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485667",
            "telephone_number": "817-579-8863",
            "fax_number": "817-579-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR SURGICARE AT GRANBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "DONITA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "202-815-3665"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "130006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00724957",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 n 6th st",
            "address_2": "#900a",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Surgicare-Granbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randall Dean Barnes, D.O.
• Bailey Alane Barnett
• Gary Neal Barron, D.D.S.
• Amanda Barstow, MOT
• Nicole Schrock Bartosh, D.O.
• Bayside Dermatology PA
• Bearfoot Shoes, LLC
• Latisha Beauchamp
• Lynn Beckler, SLP
• Dacodah Beech, FNP-C

• Ambulatory Surgical Clinic/Center in Granbury, TX
• Providers in Granbury, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.