St John's Medical Management

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ST JOHN'S MEDICAL MANAGEMENT

Doing business as

St John's Medical Center

Practice address

1050 W Mockingbird LN
Dallas, TX 75247-5120

Phone

(214) 637-1616

Fax

(214) 637-9080

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Kuykendall

Title

Office Manager

Phone

(214) 637-1616

Specialties & licenses 1

Addresses

Other names 1

• St John's Medical Center Doing business as

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447476361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W MOCKINGBIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752475120",
            "telephone_number": "214-637-1616",
            "fax_number": "214-637-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W MOCKINGBIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752475120",
            "telephone_number": "214-637-1616",
            "fax_number": "214-637-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN'S MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUYKENDALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-637-1616",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amulya Srivatsa, MD
• Praveen Ranga Srungaram, MD
• SSC North Dallas Operating Company (North Dallas Rehabilitation Hospital)
• Jennifer Nassanga Ssedyabane, AGACNP-BC
• SSK Associates Inc. (Dependable Hospice Care)
• St Joseph Adolescent and Family Services
• Paul St Laurent, MSN, RN, ACNP
• Tawanna St Lewis, MS, CGC
• St. Celeste's Home Healthcare Services
• Sally St. Clair, PH.D.

• Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.