Organization Active NPI

Asu- Sanjacinto School Based Clinic

  • Community Health Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1417061128
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
License
509681 Issued in TX
Legal business name
ASU- SANJACINTO SCHOOL BASED CLINIC
Practice address
800 Spaulding St
San Angelo, TX 76903-4930
Phone
(325) 655-7969
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Linda Ferguson
Title
Director
Phone
(325) 655-7969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LC1500X 509681 TX Primary

Addresses

Primary practice location

800 Spaulding St
San Angelo, TX 76903-4930

Mailing address

223 S Abe St
San Angelo, TX 76903-6305
Phone (325) 655-7969

National Provider Directory

National Provider Directory

Locations

800 Spaulding St
San Angelo, TX 76903
Phone (325) 617-5845

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1417061128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S ABE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036305",
            "telephone_number": "325-655-7969",
            "fax_number": "325-655-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPAULDING ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769034930",
            "telephone_number": "325-655-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASU- SANJACINTO SCHOOL BASED CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "325-655-7969"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": "TX",
            "license": "509681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.