NPIMap

Organization Active NPI

West Texas a&M University Student Medical Services

  • Student Health Clinic/Center
  • Canyon, TX
National Provider Identifier
1407967599
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
WEST TEXAS A&M UNIVERSITY STUDENT MEDICAL SERVICES
Practice address
2620 N Russel Long Blvd
Virgil Henson Activities Center Room 104
Canyon, TX 79016-0001
Phone
(806) 651-3287
Fax
(806) 651-3289
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Authorized official

Name
Luanne Rickwartz, R.N.
Title
Director
Phone
(806) 651-3287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

2620 N Russel Long Blvd
Virgil Henson Activities Center Room 104
Canyon, TX 79016-0001

Mailing address

Wtamu PO Box 61401
West Texas a&M University Student Medical Services
Canyon, TX 79016-0001
Phone (806) 651-3287

Other identifiers 1

IdentifierTypeStateIssuer
91914669OtherTXTPI

Other names 1

  • Student Medical Services Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
West Texas Am University Student Medical Services2 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.

Locations

2403 Russell Long Blvd
Canyon, TX 79016
Phone (806) 651-1000

2402 N 3rd Ave
Canyon, TX 79016

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1407967599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WTAMU PO BOX 61401",
            "address_2": "WEST TEXAS A&M UNIVERSITY STUDENT MEDICAL SERVICES",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790160001",
            "telephone_number": "806-651-3287",
            "fax_number": "806-651-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N RUSSEL LONG BLVD",
            "address_2": "VIRGIL HENSON ACTIVITIES CENTER ROOM 104",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790160001",
            "telephone_number": "806-651-3287",
            "fax_number": "806-651-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS A&M UNIVERSITY STUDENT MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "RICKWARTZ",
        "authorized_official_first_name": "LUANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "806-651-3287",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "91914669",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Medical Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Student Medical Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Canyon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.