Organization Active NPI

St Marys Family Clinic PLLC

  • Clinic/Center
  • Carrollton, TX
National Provider Identifier
1619697877
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ST MARYS FAMILY CLINIC PLLC
Practice address
3730 N Josey LN Ste 120
Carrollton, TX 75007-2439
Phone
(972) 999-3593
NPI assigned
Aug 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Remi ThomasNPI 1962089052
Title
Owner
Phone
(972) 999-3593

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3730 N Josey LN Ste 120
Carrollton, TX 75007-2439

Mailing address

3730 N Josey LN Ste 120
Carrollton, TX 75007-2439
Phone (972) 999-3593

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719002513 TX Part B Supplier - Clinic/Group Practice 3476913641 Receives reassigned benefits from 1 practitioner
Practice locations: Carrollton, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1619697877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 N JOSEY LN STE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750072439",
            "telephone_number": "972-999-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 N JOSEY LN STE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750072439",
            "telephone_number": "972-999-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS FAMILY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "REMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-999-3593"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.