Liberty County Hospital District No 1

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIBERTY COUNTY HOSPITAL DISTRICT NO 1

Doing business as

LDRMC Profession Services

Practice address

1353 N Travis
Liberty, TX 77575-3549

Phone

(936) 336-7316

Fax

(936) 336-2862

NPI assigned

Mar 18, 2011

Last updated

Sep 26, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

LIBERTY COUNTY HOSPITAL DISTRICT NO 1As reported in NPPES

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

Authorized official

Name

Mrs. Rhonda Campbell

Title

Ceo

Phone

(936) 336-7316

Specialties & licenses 3

Addresses

Other names 1

• LDRMC Profession Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Liberty County Hospital District No 1

  dba Liberty Dayton Medical Specialty Clinic

  • Rural Health Clinic/Center
  • Liberty, TX
  • NPI 1386401560

  O20160919002678

  Same enrollment

Part of

Ldrmc Professional Services

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Liberty County Hospital District No. 1

  dba River Pointe of Trinity Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • Trinity, TX
  • NPI 1336190347

  Member Of

  NPD member

All facility ownership & control disclosures 38

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 30

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.

• Jenny Glenn

  • Acute Care Nurse Practitioner
  • Liberty, TX
  • NPI 1164180485
  Medicare reassignment Care Compare group NPD
• Nitin Mahajan, M.D.

  • Interventional Cardiology Physician
  • Houston, TX
  • NPI 1467561902
  Medicare reassignment Care Compare group NPD
• Victoria Dianne Manning, FNP-BC

  • Family Nurse Practitioner
  • Liberty, TX
  • NPI 1053033530
  Medicare reassignment Care Compare group NPD
• Heather Reed, PA-C

  • Medical Physician Assistant
  • Liberty, TX
  • NPI 1487889960
  Medicare reassignment Care Compare group NPD
• Syrila Denean Bossert, WHNP

  • Women's Health Nurse Practitioner
  • Jefferson City, MO
  • NPI 1902348956

  TX

  Medicare reassignment Care Compare group NPD
• Sharde Michelle Angelle

  • Nurse Practitioner
  • Houston, TX
  • NPI 1831619014
  Medicare reassignment Care Compare group
• Amanuel Abreha, M.D.

  • Internal Medicine Physician
  • Liberty, TX
  • NPI 1821059841
  Medicare reassignment NPD
• Patrick James Asay, MD

  • Emergency Medicine Physician
  • El Paso, TX
  • NPI 1932724630
  Medicare reassignment NPD
• Joseph E T Bales, M.D.

  • Emergency Medicine Physician
  • College Station, TX
  • NPI 1700142387
  Medicare reassignment NPD
• Mark Ryan Boyle, MD

  • Emergency Medicine Physician
  • College Station, TX
  • NPI 1861519274
  Medicare reassignment NPD
• Stace Breland, DO

  • Emergency Medicine Physician
  • Aubrey, TX
  • NPI 1821417155

  Family Medicine

  Medicare reassignment NPD
• Meredith Gault Brown, M.D.

  • Emergency Medicine Physician
  • Katy, TX
  • NPI 1639306574
  Medicare reassignment NPD

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1528367356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 N TRAVIS",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775753549",
            "telephone_number": "936-336-7316",
            "fax_number": "936-336-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 N TRAVIS",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775753549",
            "telephone_number": "936-336-7316",
            "fax_number": "936-336-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNTY HOSPITAL DISTRICT NO 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY COUNTY HOSPITAL DISTRICT NO 1",
        "enumeration_date": "2011-03-18",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "936-336-7316",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDRMC Profession Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LDRMC Profession Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carissa Kathryn Kruckemeyer, PHARMD
• Jennifer Landaverde
• Liberty County Co-Op
• Liberty County Hospital District No 1 (Liberty Dayton Regional Medical Center)
• Liberty County Hospital District No 1 (Liberty Dayton Medical Specialty Clinic)
• Liberty County Hospital District No 1 (Liberty Dayton Medical Clinic)
• Liberty County Hospital District No. 1 (The Heights of Tomball)
• Liberty County Hospital District No. 1
• Liberty Dayton Community Hospital
• Liberty Dayton Community Hospital

• Family Medicine Physician in Liberty, TX
• Providers in Liberty, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.