Fairmount Family Practice, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

AP123751 Issued in TX

Legal business name

FAIRMOUNT FAMILY PRACTICE, PLLC

Practice address

3732 Fairdale Rd
Hemphill, TX 75948

Phone

(409) 579-2044

Fax

(409) 579-2104

NPI assigned

Jun 30, 2017

Last updated

Jul 21, 2022By 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

Priscilla Pipes, RHIT

Title

Credentialing Administration

Phone

(936) 615-4265

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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.

• Sharon K Byley, RN, FNP-C

  • Family Nurse Practitioner
  • Hemphill, TX
  • NPI 1922114206
  Medicare reassignment
• Kelsie Gilley, APRN

  • Family Nurse Practitioner
  • Beaumont, TX
  • NPI 1023623964
  NPD (past)

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801317722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 FAIRDALE RD",
            "city": "HEMPHILL",
            "state": "TX",
            "postal_code": "75948",
            "telephone_number": "409-579-2044",
            "fax_number": "409-579-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 FAIRDALE RD",
            "city": "HEMPHILL",
            "state": "TX",
            "postal_code": "75948",
            "telephone_number": "409-579-2044",
            "fax_number": "409-579-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PIPES",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATION",
        "authorized_official_telephone_number": "936-615-4265",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "AP123751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922114206",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Anne Castillo
• Susan P. Cowgill, M.A., CCC-A
• Michael Dickinson, PA
• East Sabine Senior Services Inc
• Stephanie Elliott, L.A.T.
• Foster Home Care Services, LLC (Always There Home Care)
• Michelle Merritt Gary
• Mareike Gay
• Gary Robert Golden, O.D.
• William Stanley Gore, M.D.

• Primary Care Clinic/Center in Hemphill, TX
• Providers in Hemphill, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.