NPIMap

Organization Active NPI

Hondo Hospital Authority

Doing business as Medina Community Hospital

  • Family Medicine Physician
  • Hondo, TX
National Provider Identifier
1750575965
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HONDO HOSPITAL AUTHORITY
Doing business as
Medina Community Hospital
Practice address
3100 Avenue E
Hondo, TX 78861-3534
Phone
(830) 426-7700
Fax
(830) 426-7975
NPI assigned
Aug 30, 2007
Last updated
Apr 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Mrs. Delia Dominguez
Title
Medicaid Collector
Phone
(830) 426-7874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3100 Avenue E
Hondo, TX 78861-3534

Mailing address

3100 Avenue E
Hondo, TX 78861-3534
Phone (830) 426-7700

Other identifiers 1

IdentifierTypeStateIssuer
082496301MedicaidTX

Other names 1

  • Medina Community Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750575965. Details of each certification follow.

Hospital certification: CCN 450309

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MEDINA COMMUNITY HOSPITAL
Certification status
Terminated Other: provider status change, Mar 31, 2002
Provider type (POS)
Hospital – Short-term
Participating since
Apr 21, 1977
Last certification
Feb 22, 2001
Beds
34 (29 certified)
Ownership / control type
Local
Facility address
3100 Avenue E
Hondo, TX 78861

National Provider Directory

National Provider Directory
Tax ID family
Hondo Hospital Authority4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1750575965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 AVENUE E",
            "city": "HONDO",
            "state": "TX",
            "postal_code": "788613534",
            "telephone_number": "830-426-7700",
            "fax_number": "830-426-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 AVENUE E",
            "city": "HONDO",
            "state": "TX",
            "postal_code": "788613534",
            "telephone_number": "830-426-7700",
            "fax_number": "830-426-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONDO HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "DELIA",
        "authorized_official_title_or_position": "MEDICAID COLLECTOR",
        "authorized_official_telephone_number": "830-426-7874",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082496301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medina Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hondo, TX

Sources for this page

Verify at the official NPI Registry.