Organization Active NPI

Magnolia First Family Medicine P.a.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1578666756
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAGNOLIA FIRST FAMILY MEDICINE P.A.
Practice address
2200 Southwest Fwy
Suite333
Houston, TX 77098-4710
Phone
(713) 520-5450
Fax
(713) 520-5458
NPI assigned
Sep 6, 2006
Last updated
Dec 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Authorized official

Name
Shawn D Burton, M.D.NPI 1720023096
Title
President,Ceo
Phone
(713) 520-5450

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 Physician 207Q00000X Primary

Addresses

Primary practice location

2200 Southwest Fwy
Suite333
Houston, TX 77098-4710

Mailing address

2200 Southwest Fwy
Suite333
Houston, TX 77098-4710
Phone (713) 520-5450

Other identifiers 1

IdentifierTypeStateIssuer
169962101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041204000117 TX Part B Supplier - Clinic/Group Practice 7214993914 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1032478Magnolia First Family Medicine2200 Southwest Freeway Ste 333, Houston, TX 77098Provider-performed microscopyOct 24, 2026

National Provider Directory

National Provider Directory

Locations

2200 Southwest Fwy
Ste 333
Houston, TX 77098
Phone (713) 520-5450

6222 Richmond Ave
Ste 633
Houston, TX 77057

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15725/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1578666756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SOUTHWEST FWY",
            "address_2": "SUITE333",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984710",
            "telephone_number": "713-520-5450",
            "fax_number": "713-520-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SOUTHWEST FWY",
            "address_2": "SUITE333",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984710",
            "telephone_number": "713-520-5450",
            "fax_number": "713-520-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FIRST FAMILY MEDICINE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT,CEO",
        "authorized_official_telephone_number": "713-520-5450",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169962101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.