Wichita Falls Endoscopy Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

008194 Issued in TX

Legal business name

WICHITA FALLS ENDOSCOPY CENTER

Practice address

1500 9TH St
Wichita Falls, TX 76301-4323

Phone

(940) 761-9034

NPI assigned

Jun 20, 2005

Last updated

Aug 22, 2020By 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

Mrs. Staci Koetter

Title

Business Office Manager

Phone

(940) 761-9034

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Wichita Falls Endoscopy CenterCCN 45C0001394

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Wichita Falls Endoscopy Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Wichita Falls Endoscopy Center, LP

  dba Wichita Falls Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Wichita Falls, TX
  • NPI 1164818191
  NPD tax ID

Member of 1

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

• United Regional Health Care System Inc

  dba United Regional Heath Care System

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448

  Member Of

  NPD member

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407851090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 9TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014323",
            "telephone_number": "940-761-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 9TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014323",
            "telephone_number": "940-761-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOETTER",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "940-761-9034",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "008194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "008194",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wichita Falls Cardiac Care PA
• Wichita Falls Care Center
• Wichita Falls Care Center Inc (Wichita Falls Care Center)
• Wichita Falls Dentures and Dental Implants, PLLC.
• Wichita Falls Emergency Center, LLC (ER Now)
• Wichita Falls Endoscopy Center, LP (Wichita Falls Endoscopy Center)
• Wichita Falls Family Dental PLLC (Star Image Dentistry)
• Wichita Falls Gastroenterology Associates
• Wichita Falls Hearing LLC
• Wichita Falls Heart Clinic PLLC

• Ambulatory Surgical Clinic/Center in Wichita Falls, TX
• Providers in Wichita Falls, 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 Aug 22, 2020; 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.