NPIMap

Organization Active NPI

Memorial Hospital of Texas County Authority

Doing business as High Plains General Surgical Clinic

  • Surgery Physician
  • Guymon, OK
National Provider Identifier
1750629671
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY
Doing business as
High Plains General Surgical Clinic
Practice address
1753 N Roosevelt St Ste 1
Guymon, OK 73942-2729
Phone
(580) 468-3035
Fax
(580) 468-3442
NPI assigned
Jan 28, 2013
Last updated
Aug 3, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HOSPITAL OF TEXAS COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Authorized official

Name
William Ermann
Title
Ceo
Phone
(580) 338-6515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1753 N Roosevelt St Ste 1
Guymon, OK 73942-2729

Mailing address

520 Medical Dr
Guymon, OK 73942-4438
Phone (580) 338-6515

Other names 1

  • High Plains General Surgical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000739 OK Part B Supplier - Clinic/Group Practice 5395647655 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Guymon, OK; Hooker, OK

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital15 organizations share this tax ID, including this one
Part of
Memorial Hospital

Other organizations with this tax ID 14

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

View all 14

Locations

1753 N Roosevelt St
Ste 1
Guymon, OK 73942
Phone (580) 468-3035

Practitioners & affiliated clinicians

Practitioners 1

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": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1750629671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739424438",
            "telephone_number": "580-338-6515",
            "fax_number": "580-468-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 N ROOSEVELT ST STE 1",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739422729",
            "telephone_number": "580-468-3035",
            "fax_number": "580-468-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL OF TEXAS COUNTY",
        "enumeration_date": "2013-01-28",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "ERMANN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-338-6515"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Plains General Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "High Plains General Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guymon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.