Exceptional H C Orange LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

EXCEPTIONAL H C ORANGE LLC

Practice address

1321 N 16TH St
Orange, TX 77630-3609

Phone

(469) 341-7800

NPI assigned

Jun 5, 2019

Last updated

Jul 23, 2020By 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

Saeed S Mahboubi

Title

Cfo

Phone

(469) 341-7800

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 1508424490. Details of each certification follow.

• CCN 670223 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 670223

Legal name

EXCEPTIONAL H C ORANGE

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

May 8, 2020

Last certification

May 8, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

1321 N. 16TH St
Orange, TX 77630

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1508424490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N 16TH ST",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776303609",
            "telephone_number": "469-341-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N 16TH ST",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776303609",
            "telephone_number": "469-341-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEPTIONAL H C ORANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "MAHBOUBI",
        "authorized_official_first_name": "SAEED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "469-341-7800"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Services of Texas PA
• Carley Kay Erickson, M.S., CCC-SLP
• Justin Aaron Evans, CF-SLP
• Peter Shelby Evans, M.D., FACEP
• Evelyn Anderson LPC
• Exceptional Physicians Group Orange PLLC
• Exceptional Port Arthur LLC
• Baher Fahmy, R.PH, PHD
• Family & Psychological Center
• John Fernon Jr.

• Emergency Care Clinic/Center in Orange, TX
• Providers in Orange, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.