NPIMap

Organization Active NPI

Ess of Nacogdoches LLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
National Provider Identifier
1780139956
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ESS OF NACOGDOCHES LLC
Practice address
1204 N Mound St
Nacogdoches, TX 75961-4027
Phone
(936) 564-4611
NPI assigned
Aug 17, 2016
Last updated
Aug 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
Ron Weiss
Title
President
Phone
(866) 931-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1204 N Mound St
Nacogdoches, TX 75961-4027

Mailing address

17304 Preston Rd
Dallas, TX 75252-5618
Phone (866) 931-8882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161021000335 TX Part B Supplier - Clinic/Group Practice 3375821630 Receives reassigned benefits from 130 practitioners
Practice locations: Nacogdoches, TX

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 129

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 129

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1780139956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17304 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525618",
            "telephone_number": "866-931-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESS OF NACOGDOCHES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-931-8882"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.