East Texas Medical Center Pittsburg

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

000438 Issued in TX

Legal business name

EAST TEXAS MEDICAL CENTER PITTSBURG

Practice address

2701 U.S. Hwy 271 N
Pittsburg, TX 75686-4289

Phone

(903) 946-5000

Fax

(903) 946-5598

NPI assigned

May 9, 2006

Organization subpart

No

Name

Mr. W Perry Henderson

Title

Administrator

Phone

(903) 856-4501

• ETMC Pittsburg Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 15, 2009.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1720037559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1304",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756862203",
            "telephone_number": "903-946-5519",
            "fax_number": "903-946-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 U.S. HWY 271 N",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756864289",
            "telephone_number": "903-946-5000",
            "fax_number": "903-946-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER PITTSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-856-4501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "NA",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "000438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138374701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HH0096",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138374706",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "C635",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00J75T",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CF8842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC Pittsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Texas Home Health Services LLC
• East Texas Medical Center Home Health North
• East Texas Medical Center Home Services
• East Texas Medical Center Pittsburg
• East Texas Medical Center Pittsburg
• East Texas Medical Center Pittsburg
• Ronnie Earl Frazier Jr.
• Sarah Friberg, CPM, LM
• Jessica Rubit Garcia, LVN
• Tiffanie Garcia, RN

• All providers in Pittsburg, TX
• Critical Access Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.