NPIMap

Organization Active NPI

Robert R McMinn

  • Clinic/Center
  • Nacogdoches, TX
National Provider Identifier
1437340601
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
511503 Issued in TX
Legal business name
ROBERT R MCMINN
Practice address
5300 North St
Nacogdoches, TX 75965-1370
Phone
(936) 687-3242
Fax
(936) 687-3242
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
Mr. Robert R McMinn II, CRNA
Title
Taxonomy X
Phone
(936) 546-3733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 511503 TX Primary

Addresses

Primary practice location

5300 North St
Nacogdoches, TX 75965-1370

Mailing address

PO Box 1043
Crockett, TX 75835-1043
Phone (936) 687-3242

Other identifiers 2

IdentifierTypeStateIssuer
0005190215OtherAETNA
81214UOtherTXBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1437340601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1043",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351043",
            "telephone_number": "936-687-3242",
            "fax_number": "936-687-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651370",
            "telephone_number": "936-687-3242",
            "fax_number": "936-687-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT R MCMINN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "MCMINN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "TAXONOMY  X",
        "authorized_official_telephone_number": "936-546-3733",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "511503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005190215",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81214U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.