Ten Broeck Tennessee Physicians

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TEN BROECK TENNESSEE PHYSICIANS

Doing business as

CHI St. Joseph Health Madison Hospital d/b/a Senior Renewal Center

Practice address

100 W Cross St
Madisonville, TX 77864-2432

Phone

(936) 349-1671

Fax

(936) 349-1672

NPI assigned

Dec 16, 2019

Last updated

Dec 16, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

TEN BROECK TENNESSEE PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Glenda F Guy

Title

Director Compliance

Phone

(931) 783-2511

Specialties & licenses 1

Addresses

Other names 1

• CHI St. Joseph Health Madison Hospital d/b/a Senior Renewal Center Doing business as

Part of

Ten Broeck Tennessee Physicians

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1659919108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CROSS ST",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778642432",
            "telephone_number": "936-349-1671",
            "fax_number": "936-349-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CROSS ST",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778642432",
            "telephone_number": "936-349-1671",
            "fax_number": "936-349-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEN BROECK TENNESSEE PHYSICIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEN BROECK TENNESSEE PHYSICIANS",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "GUY",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR COMPLIANCE",
        "authorized_official_telephone_number": "931-783-2511"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI St. Joseph Health Madison Hospital d/b/a Senior Renewal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sawyer Sams, DDS
• St. Joseph Regional Health Center (St. Joseph J.B. Heath Family Health Center)
• Peter Vincent Sullivan, M.D.
• Summit LTC Madisonville, LLC
• Superior Telemedicine, PLLC
• Texas Loving Care Senior Living
• April Thompson, FNP-C
• Robert Thomas Tieperman, D.C.
• Traditions Health Care of Madisonville, LLC (Traditions Health)
• Thadeo Gonzales Trivilegio, ASCPI,CM

• Mental Health Clinic/Center (Including Community Mental Health Center) in Madisonville, TX
• Providers in Madisonville, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.