NPIMap

Organization Active NPI

Ess of Crockett, LLC

  • Emergency Medicine Physician
  • Crockett, TX
National Provider Identifier
1649988635
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ESS OF CROCKETT, LLC
Practice address
1100 E Loop 304
Crockett, TX 75835-1810
Phone
(936) 546-3891
NPI assigned
Nov 9, 2022
Last updated
Nov 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Ron Weiss
Title
Owner
Phone
(866) 931-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1100 E Loop 304
Crockett, TX 75835-1810

Mailing address

17304 Preston Rd Ste 1400
Dallas, TX 75252-5633
Phone (866) 931-8882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213000258 TX Part B Supplier - Clinic/Group Practice 3678942778 Receives reassigned benefits from 42 practitioners
Practice locations: Crockett, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1649988635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17304 PRESTON RD STE 1400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525633",
            "telephone_number": "866-931-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E LOOP 304",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351810",
            "telephone_number": "936-546-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESS OF CROCKETT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-931-8882"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crockett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.