West Texas Neurosurgery PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

L4342 Issued in TX

Legal business name

WEST TEXAS NEUROSURGERY PA

Practice address

8050 E Highway 191
Suite 212
Odessa, TX 79765-8613

Phone

(432) 580-4700

Fax

(432) 332-2678

NPI assigned

Mar 2, 2007

Last updated

Feb 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John K Dorman, M.D.NPI 1215030333

Title

President/Owner

Phone

(432) 580-4700

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18076/brand/1/csg/1/fhir/r4

Practitioners 6

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.

• John Kyle Dorman, MD

  • Neurological Surgery Physician
  • Odessa, TX
  • NPI 1215030333
  Medicare reassignment Care Compare group Authorized official
• Megan Riegle, PA-C

  • Physician Assistant
  • Stillwater, MN
  • NPI 1063131365

  TX

  Medicare reassignment Care Compare group
• Martha Nunez

  • Psychiatric/Mental Health Nurse Practitioner
  • Odessa, TX
  • NPI 1679962104
  Medicare reassignment NPD
• Celeste Renea Menzer, PA

  • Physician Assistant
  • Shenandoah, TX
  • NPI 1477163590
  Medicare reassignment
• Thomas Chow, M.D.

  • Neurological Surgery Physician
  • Longview, TX
  • NPI 1750367876
  NPD (past)
• Amy N Girand, PA

  • Physician Assistant
  • Gunnison, CO
  • NPI 1770596272
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1760511315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 E HIGHWAY 191",
            "address_2": "SUITE 212",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658613",
            "telephone_number": "432-580-4700",
            "fax_number": "432-332-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 E HIGHWAY 191",
            "address_2": "SUITE 212",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658613",
            "telephone_number": "432-580-4700",
            "fax_number": "432-332-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS NEUROSURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "432-580-4700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "L4342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165059001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "L4342",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0004QF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166114201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL NUMBER",
            "identifier": "8AJ418",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.