NPIMap

Organization Active NPI

SPMG Signature Pampa Medical Group

Doing business as Pampa Medical Group

  • Family Medicine Physician
  • Pampa, TX
National Provider Identifier
1770716896
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPMG SIGNATURE PAMPA MEDICAL GROUP
Doing business as
Pampa Medical Group
Practice address
3023 Perryton Pkwy Ste 101
Pampa, TX 79065-2817
Phone
(806) 665-0801
NPI assigned
Aug 25, 2009
Last updated
Nov 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Authorized official

Name
Twila Thomas
Title
Interim Ceo
Phone
(806) 663-5500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X

Addresses

Primary practice location

3023 Perryton Pkwy Ste 101
Pampa, TX 79065-2817

Mailing address

One Medical Plaza
C/O Pampa Medical Group
Pampa, TX 79065-2814
Phone (806) 663-5695

Other identifiers 1

IdentifierTypeStateIssuer
210094301MedicaidTX

Other names 1

  • Pampa Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091221000548 TX Part B Supplier - Clinic/Group Practice 3375683436 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Borger, TX; Pampa, TX

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

503 W 1st St
Ste A
Borger, TX 79007
Phone (806) 591-2270

2931 Perryton Pkwy
Pampa, TX 79065
Phone (806) 665-6511

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1770716896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL PLAZA",
            "address_2": "C/O PAMPA MEDICAL GROUP",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652814",
            "telephone_number": "806-663-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 PERRYTON PKWY STE 101",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652817",
            "telephone_number": "806-665-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPMG SIGNATURE PAMPA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "TWILA",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "806-663-5500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210094301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pampa Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pampa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.