Active NPI
Cep America LLC
- Emergency Medicine Physician
- Texarkana, TX
National Provider Identifier
1891057618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- CEP AMERICA LLC
- Practice address
- 1000 Pine St
Texarkana, TX 75501-5100 - Phone
- (903) 798-8000
- NPI assigned
- Jun 8, 2012
- 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
- Dr. Theophile Koury, MD
- Title
- Coo
- Phone
- (510) 350-2600
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Family Medicine Physician | 207Q00000X |
Addresses
Primary practice location
1000 Pine St
Texarkana, TX 75501-5100
Mailing address
2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120813000819 | TX | Part B Supplier - Clinic/Group Practice | 6608056171 |
Receives reassigned benefits from 93 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: El Paso, TX |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339113600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1377734400000",
"number": "1891057618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST",
"address_2": "STE 900",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "510-350-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 PINE ST",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755015100",
"telephone_number": "903-798-8000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CEP AMERICA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-08",
"last_updated": "2013-08-29",
"status": "A",
"authorized_official_last_name": "KOURY",
"authorized_official_first_name": "THEOPHILE",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "510-350-2600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.