NPIMap

Organization Active NPI

Scott & White Hospital - Taylor

  • Nurse Practitioner
  • Taylor, TX
National Provider Identifier
1659548568
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SCOTT & WHITE HOSPITAL - TAYLOR
Practice address
305 Mallard LN
Taylor, TX 76574-1208
Phone
(512) 352-7611
Fax
(512) 352-4734
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Alice Cantu
Title
System Director, CBS
Phone
(254) 215-9719

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Multi-Specialty Clinic/Center 261QM1300X TX
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

305 Mallard LN
Taylor, TX 76574-1208

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 1

IdentifierTypeStateIssuer
136327711MedicaidTX

Other names 1

  • BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000059 TX Part B Supplier - Clinic/Group Practice 1456246750 Receives reassigned benefits from 118 practitioners
1 other NPI on this enrollment
Practice locations: Taylor, TX

National Provider Directory

National Provider Directory
Tax ID family
Johns Community Hosp ER5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 134

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

View all 134

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1659548568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-7611",
            "fax_number": "512-352-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE HOSPITAL - TAYLOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR, CBS",
        "authorized_official_telephone_number": "254-215-9719"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136327711",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.