NPIMap

Individual provider Active NPI

Jon M Rich, D.O.

  • Family Medicine Physician
  • Gun Barrel City, TX
National Provider Identifier
1770520942
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M0239 Issued in TX
Practice address
2412 W Main St
Gun Barrel City, TX 75156-3638
Phone
(903) 309-9373
Fax
(903) 405-4573
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M0239 TX Primary

Addresses

Primary practice location

2412 W Main St
Gun Barrel City, TX 75156-3638

Mailing address

2412 W Main St
Gun Barrel City, TX 75156-3638
Phone (903) 309-9373

Other identifiers 2

IdentifierTypeStateIssuer
181600102MedicaidTX
86241YOtherTXBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061004000544 TX Practitioner - Family Practice 2668478280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2412 W Main St
Gun Barrel City, TX 75156-3638
Phone (903) 309-9373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Enriched Life Medical, PLLC Family Medicine Current Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Sep 15, 2011 Accepting new patients
Concord Medical Group PLLC CurrentSince Sep 15, 2011 Accepting new patients
Enriched Life Medical Family Medicine CurrentSince Mar 2, 2024 Accepting new patients

Locations

2412 W Main St
Gun Barrel City, TX 75156
Phone (903) 309-9373

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1770520942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 W MAIN ST",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751563638",
            "telephone_number": "903-309-9373",
            "fax_number": "903-405-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 W MAIN ST",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751563638",
            "telephone_number": "903-309-9373",
            "fax_number": "903-405-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "JON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181600102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "86241Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gun Barrel City, TX

Sources for this page

Verify at the official NPI Registry.