Organization Active NPI

Mid-County Family Care PLLC

  • Family Nurse Practitioner
  • Port Neches, TX
National Provider Identifier
1487052320
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
684913 Issued in TX
Legal business name
MID-COUNTY FAMILY CARE PLLC
Practice address
882 Sierra Dr
Port Neches, TX 77651-5607
Phone
(409) 722-1234
Fax
(409) 722-3270
NPI assigned
Dec 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Kimberly Ann YoesNPI 1902945330
Title
Owner/Provider
Phone
(409) 722-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 684913 TX Primary

Addresses

Primary practice location

882 Sierra Dr
Port Neches, TX 77651-5607

Mailing address

882 Sierra Dr
Port Neches, TX 77651-5607
Phone (409) 722-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150721001359 TX Part B Supplier - Clinic/Group Practice 0648583583 Receives reassigned benefits from 3 practitioners
Practice locations: Port Neches, TX

National Provider Directory

National Provider Directory

Locations

882 Sierra Dr
Port Neches, TX 77651
Phone (409) 722-1234

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1487052320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "409-722-1234",
            "fax_number": "409-722-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "409-722-1234",
            "fax_number": "409-722-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COUNTY FAMILY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "YOES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "409-722-1234"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "684913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Neches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.