NPIMap

Organization Active NPI

Clinical Practice Support Services

  • Primary Care Clinic/Center
  • Mansfield, TX
National Provider Identifier
1881888907
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CLINICAL PRACTICE SUPPORT SERVICES
Practice address
1811 Highway 287 N Ste 150
Mansfield, TX 76063-7595
Phone
(817) 473-3979
Fax
(682) 518-8919
NPI assigned
Aug 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Eugene Gleeson
Title
Director of Business Services
Phone
(817) 473-3979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1811 Highway 287 N Ste 150
Mansfield, TX 76063-7595

Mailing address

1811 Highway 287 N Ste 150
Mansfield, TX 76063-7595
Phone (817) 473-3979

Other names 1

  • Mansfield Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000340 TX Part B Supplier - Clinic/Group Practice 0840245312 Receives reassigned benefits from 6 practitioners
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

1811 Highway 287 N
Ste 150
Mansfield, TX 76063
Phone (817) 473-3979

Practitioners & affiliated clinicians

Practitioners 7

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": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1881888907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 HIGHWAY 287 N STE 150",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637595",
            "telephone_number": "817-473-3979",
            "fax_number": "682-518-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 HIGHWAY 287 N STE 150",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637595",
            "telephone_number": "817-473-3979",
            "fax_number": "682-518-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PRACTICE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "GLEESON",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "817-473-3979"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mansfield Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.