Firm Foundations Healthcare Clinic PC

Key facts

NPI

1437991973

Entity type

Organization (NPI type 2)

Primary specialty

Rural Health Clinic/Center 261QR1300X

Legal business name

FIRM FOUNDATIONS HEALTHCARE CLINIC PC

Practice address

2708 Jefferson Dr
Ste a
Liberty, TX 77575-1036

Phone

(936) 334-8800

Fax

(936) 334-8801

NPI assigned

Jun 6, 2024

Organization subpart

No

Authorized official

Name

Stephanie Janel Smith, RT(R)

Title

Clinic Administrator

Phone

(936) 334-8800

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Raymond J Luna, MD Adult Medicine Physician · Livingston, TX · NPI 1740280692
  CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST
• Brandon Kyle Smith, PA-C Family Medicine Physician · Liberty, TX · NPI 1265690309
  CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · W-2 MANAGING EMPLOYEE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Firm Foundations Healthcare Clinic PC Family Medicine Physician · Liberty, TX · NPI 1447403399
  Same PAC ID 1052475217

Practitioners 5

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

• Brandon Kyle Smith, PA-C Family Medicine Physician · Liberty, TX · NPI 1265690309
  Care Compare group NPD
• Mary Elizabeth Poston, PA-C Medical Physician Assistant · Liberty, TX · NPI 1205170156
  Care Compare group
• Grayson Stockwell, FNP-C Family Nurse Practitioner · Dayton, TX · NPI 1861369068
  Care Compare group
• William S Burkes, M.D. Sleep Medicine (Internal Medicine) Physician · Beaumont, TX · NPI 1609879378
  NPD
• Raymond J Luna, MD Adult Medicine Physician · Livingston, TX · NPI 1740280692
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Rural health clinic certification: CCN 678939

Legal name

FIRM FOUNDATIONS HEALTHCARE CLINIC PC

Doing business as

FIRM FOUNDATIONS HEALTHCARE CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 24, 2025

Last certification

Feb 24, 2025

Ownership / control type

1B

Organization structure

Other · Proprietary

Incorporated

Oct 20, 2008 in TX

Enrollment address

2708 Jefferson Dr
Ste a
Liberty, TX 77575-1036

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 6, 2024.

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1437991973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 JEFFERSON DR",
            "address_2": "STE A",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775751036",
            "telephone_number": "936-334-8800",
            "fax_number": "936-334-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 JEFFERSON DR",
            "address_2": "STE A",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775751036",
            "telephone_number": "936-334-8800",
            "fax_number": "936-334-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRM FOUNDATIONS HEALTHCARE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "JANEL",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "936-334-8800",
        "authorized_official_credential": "RT(R)"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, TX

• Ess of South Texas LLC
• Family Christian Care Service
• Faresh Mehta, O.D., P.a.
• Britney Ferguson
• Letha Ferguson, FNPC
• Firm Foundations Healthcare Clinic PC
• Michael Fortune
• Lessie Frank, LVN
• Tiffany Binata Gaston, LCSW
• Jennifer Marcell Giles

All providers in Liberty, TX · Rural Health Clinic/Center in Texas