Trinity Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

TRINITY CLINIC

Practice address

307 Woodlawn
Kilgore, TX 75662-3624

Phone

(903) 983-2110

NPI assigned

Apr 18, 2007

Organization subpart

Yes

Parent organization

TRINITY CLINICAs reported in NPPES

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

Authorized official

Name

Mary Ann Harrison, CPC CMC

Title

Provider Enrollment Coordinator

Phone

(903) 510-1113

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Trinity Clinic Kilgore 2 Other name

Part of

Tyler Radiologist

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1861618779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 WOODLAWN",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623624",
            "telephone_number": "903-983-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY CLINIC",
        "enumeration_date": "2007-04-18",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "903-510-1113",
        "authorized_official_credential": "CPC CMC"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201442502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201442501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Clinic Kilgore 2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Erica Lynne Trammell, DDS
• Trinity Clinic
• U'Nique Saferides Transportation LLC
• Caitlyn J Vanmeter, FNP-C
• Valerie Michelle Vaughn-Smith, APRN,MSN, PMHNP-BC
• Vop Arabella Kilgore, LLC
• Shelly Wade, PT

• All providers in Kilgore, TX
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.