NPIMap

Organization Active NPI

Pecos County Memorial Hospital

  • Critical Access Hospital
  • Fort Stockton, TX
National Provider Identifier
1760598692
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
000356 Issued in TX
Legal business name
PECOS COUNTY MEMORIAL HOSPITAL
Practice address
387 W Ih 10
Fort Stockton, TX 79735-2700
Phone
(432) 336-2004
Fax
(432) 336-4545
NPI assigned
Aug 22, 2006
Last updated
Nov 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Mrs. Betsy Briscoe
Title
Ceo
Phone
(432) 336-4200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 000356 TX Primary
Rural Acute Care Hospital 282NR1301X 000356 TX

Addresses

Primary practice location

387 W Ih 10
Fort Stockton, TX 79735-2700

Mailing address

PO Box 1648
Fort Stockton, TX 79735-1648
Phone (432) 336-2004

Other identifiers 6

IdentifierTypeStateIssuer
130616909MedicaidTX
596656OtherTXJOINT COMMISSION ID
130616910MedicaidTX
HH0479OtherTXBLUE CROSS BLUE SHIELD TX
000356OtherTXHOSPITAL LICENSE NUMBER
130616911MedicaidTX

National Provider Directory

National Provider Directory

Locations

1710 N Front St
Fort Stockton, TX 79735
Phone (432) 336-7044

387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1760598692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797351648",
            "telephone_number": "432-336-2004",
            "fax_number": "432-336-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797352700",
            "telephone_number": "432-336-2004",
            "fax_number": "432-336-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "432-336-4200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "000356",
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TX",
            "license": "000356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130616909",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOINT COMMISSION ID",
            "identifier": "596656",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130616910",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "HH0479",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE NUMBER",
            "identifier": "000356",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130616911",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.