Texoma Primary Care Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

TEXOMA PRIMARY CARE CLINIC

Practice address

5500 Kell Blvd
Suite 500
Wichita Falls, TX 76310-1612

Phone

(940) 264-2273

NPI assigned

Sep 3, 2015

Organization subpart

Yes

Parent organization

KELL WEST REGIONAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Jerry K Myers, M.D.

Title

Ceo

Phone

(940) 696-7518

Specialties & licenses 1

Addresses

Part of

Kell West Regional Hospital LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Kell West Regional Hospital LLC

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1669480323
  NPPES parent name

Practitioners 1

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

• Kenneth Joseph Baron, PA-C

  • Surgical Physician Assistant
  • Cape Coral, FL
  • NPI 1205808516
  NPD (past)

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1497123772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KELL BLVD",
            "address_2": "SUITE 500",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763101612",
            "telephone_number": "940-264-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KELL BLVD",
            "address_2": "SUITE 500",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763101612",
            "telephone_number": "940-264-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXOMA PRIMARY CARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KELL WEST REGIONAL HOSPITAL",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-696-7518",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texoma Mobile Physical Therapy LLC
• Texoma Outpatient Surgery Center, Inc.
• Texoma Outpatient Surgery Center, Inc.
• Texoma Picc Stat
• Texoma Plastic Surgery, P.a.
• Texoma Rehab PLLC
• Texoma Rheumatology PLLC
• Texoma Specialty Care
• Texoma Surgery Center LLC
• Texoma Urology Center

• Family Nurse Practitioner in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.