NPIMap

Organization Active NPI

Fairfield Hospital District

Doing business as Freestone Health Clinic at Teague

  • Rural Health Clinic/Center
  • Teague, TX
National Provider Identifier
1679049050
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAIRFIELD HOSPITAL DISTRICT
Doing business as
Freestone Health Clinic at Teague
Practice address
604 Main St
Teague, TX 75860-1628
Phone
(903) 389-2181
Fax
(903) 389-0906
NPI assigned
Oct 23, 2018
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
John M Yeary
Title
Ceo
Phone
(903) 389-2121

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Medical Physician Assistant 363AM0700X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

604 Main St
Teague, TX 75860-1628

Mailing address

734 W Commerce St
Fairfield, TX 75840-1428
Phone (903) 389-2181

Other names 1

  • Freestone Health Clinic at Teague Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206000615 TX Part B Supplier - Clinic/Group Practice 6507149192 Receives reassigned benefits from 24 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, TX; Fairfield, TX; Teague, TX

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

734 W Commerce St
Fairfield, TX 75840
Phone (903) 389-1681

Practitioners & affiliated clinicians

Practitioners 10

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": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1679049050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 W COMMERCE ST",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758401428",
            "telephone_number": "903-389-2181",
            "fax_number": "903-389-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MAIN ST",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758601628",
            "telephone_number": "903-389-2181",
            "fax_number": "903-389-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "YEARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-389-2121"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freestone Health Clinic at Teague",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Teague, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.