Active NPI
Liberty- Dayton Regional Medical Center LLC
- Medicare Defined Swing Bed Hospital Unit
- Liberty, TX
National Provider Identifier
1508931940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- License
- 100072
- Legal business name
- LIBERTY- DAYTON REGIONAL MEDICAL CENTER LLC
- Practice address
- 1353 North Travis Street
Liberty, TX 77575-3549 - Phone
- (936) 336-7316
- Fax
- (936) 336-7772
- NPI assigned
- Nov 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Vicki A Gates, RN
- Title
- Ceo
- Phone
- (936) 336-7316
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | |||
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 100072 | TX | Primary |
Addresses
Primary practice location
1353 North Travis Street
Liberty, TX 77575-3549
Mailing address
1353 North Travis Street
Liberty, TX 77575-3549
Phone (936) 336-7316
National Provider Directory
National Provider Directory- Tax ID family
- Liberty Dayton Community Hospital
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Critical Access Hospital
- Liberty, TX
- NPI 1548376486
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Skilled Nursing Facility
- Port Arthur, TX
- NPI 1942623459
Member Of
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/1c4e6005-70c8-4848-94e1-292ffa50fed2/
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303084800000",
"number": "1508931940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1353 NORTH TRAVIS STREET",
"city": "LIBERTY",
"state": "TX",
"postal_code": "775753549",
"telephone_number": "936-336-7316",
"fax_number": "936-336-7772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1353 NORTH TRAVIS STREET",
"city": "LIBERTY",
"state": "TX",
"postal_code": "775753549",
"telephone_number": "936-336-7316",
"fax_number": "936-336-7772"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIBERTY- DAYTON REGIONAL MEDICAL CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-21",
"last_updated": "2011-04-18",
"status": "A",
"authorized_official_last_name": "GATES",
"authorized_official_first_name": "VICKI",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "936-336-7316",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": null,
"license": null,
"primary": false
},
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "TX",
"license": "100072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.