Organization Active NPI

Nacogdoches Health Partners, PLLC

  • Family Medicine Physician
  • Nacogdoches, TX
National Provider Identifier
1528518974
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N2078 Issued in TX
Legal business name
NACOGDOCHES HEALTH PARTNERS, PLLC
Practice address
4800 NE Stallings Dr
Ste 109
Nacogdoches, TX 75965-1250
Phone
(936) 559-0700
Fax
(936) 559-0500
NPI assigned
Oct 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Dr. Wilburn Edward Furniss III, MDNPI 1932398377
Title
Manager
Phone
(936) 559-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X N2078 TX Primary

Addresses

Primary practice location

4800 NE Stallings Dr
Ste 109
Nacogdoches, TX 75965-1250

Mailing address

4800 NE Stallings Dr
Ste 109
Nacogdoches, TX 75965-1250
Phone (936) 559-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161207000998 TX Part B Supplier - Clinic/Group Practice 3274813373 Receives reassigned benefits from 5 practitioners
Practice locations: Nacogdoches, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28299/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1528518974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR",
            "address_2": "STE 109",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651250",
            "telephone_number": "936-559-0700",
            "fax_number": "936-559-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR",
            "address_2": "STE 109",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651250",
            "telephone_number": "936-559-0700",
            "fax_number": "936-559-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES HEALTH PARTNERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "FURNISS",
        "authorized_official_first_name": "WILBURN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "936-559-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N2078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.