Grand Prairie Medical Center LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

GRAND PRAIRIE MEDICAL CENTER LLC

Practice address

2709 Hospital Blvd
Grand Prairie, TX 75051-1017

Phone

(504) 669-7496

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery Love

Title

Director

Phone

(469) 607-8448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487366712. Details of each certification follow.

• CCN 450149 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 450149

Legal name

DALLAS/FORT WORTH MEDICAL CENTER

Certification status

Terminated Voluntary: merger or closure, Nov 23, 2000

Provider type (POS)

Hospital – Short-term

Participating since

Feb 14, 1974

Last certification

Mar 5, 1992

Beds

162

Ownership / control type

Private (not for profit)

Facility address

2709 Hospital Blvd
Grand Prairie, TX 75051

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1487366712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 HOSPITAL BLVD",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 HOSPITAL BLVD",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511017",
            "telephone_number": "504-669-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-607-8448",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Acute Care Hospital in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• General Acute Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.