Active NPI
Nocona Medical Clinic PA
- Family Medicine Physician
- Saint Jo, TX
National Provider Identifier
1821269010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 673801
- Legal business name
- NOCONA MEDICAL CLINIC PA
- Practice address
- 108 Boggess
Saint Jo, TX 76265-0238 - Phone
- (940) 995-2410
- NPI assigned
- Mar 17, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leonard Thomas Dingler, MD
- Title
- President
- Phone
- (940) 825-3333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 673801 | TX | Primary |
Addresses
Primary practice location
108 Boggess
Saint Jo, TX 76265-0238
Mailing address
108 Boggess
Saint Jo, TX 76265-0238
Phone (940) 995-2410
Other names 1
- SAINT JO HEALTHCARE CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider DirectoryOwnership & related parties
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Jan 1, 2019 | Change of Ownership | NGH Rural Health Clinic Saint Jo |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240876800000",
"number": "1821269010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 BOGGESS",
"city": "SAINT JO",
"state": "TX",
"postal_code": "762650238",
"telephone_number": "940-995-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 BOGGESS",
"city": "SAINT JO",
"state": "TX",
"postal_code": "762650238",
"telephone_number": "940-995-2410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOCONA MEDICAL CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-17",
"last_updated": "2009-04-28",
"status": "A",
"authorized_official_last_name": "DINGLER",
"authorized_official_first_name": "LEONARD",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "940-825-3333",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "673801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SAINT JO HEALTHCARE CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Jo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.