NPIMap

Organization Active NPI

Utmb

  • Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1497105084
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP131092 Issued in TX
Legal business name
UTMB
Practice address
3060 FM 3514
Medical Department - Ms. Adodo
Beaumont, TX 77705-7635
Phone
(409) 722-5255
Fax
(409) 719-4157
NPI assigned
Jun 15, 2016
Last updated
Jun 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Authorized official

Name
Mark Barber, D.O.
Title
Medical Director
Phone
(409) 722-5255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP131092 TX Primary

Addresses

Primary practice location

3060 FM 3514
Medical Department - Ms. Adodo
Beaumont, TX 77705-7635

Mailing address

3060 FM 3514
Beaumont, TX 77705-7635
Phone (409) 722-5255

National Provider Directory

National Provider Directory

Locations

3060 FM 3514
Beaumont, TX 77705
Phone (409) 722-5255

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1497105084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 FM 3514",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777057635",
            "telephone_number": "409-722-5255",
            "fax_number": "409-719-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 FM 3514",
            "address_2": "MEDICAL DEPARTMENT - MS. ADODO",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777057635",
            "telephone_number": "409-722-5255",
            "fax_number": "409-719-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "409-722-5255",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP131092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.