Active NPI
Exceptional Amarillo N Coulter LLC
- Emergency Care Clinic/Center
- Amarillo, TX
National Provider Identifier
1891343455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Care Clinic/Center
- Legal business name
- EXCEPTIONAL AMARILLO N COULTER LLC
- Practice address
- 2101 S Coulter St
Amarillo, TX 79106-2513 - Phone
- (469) 341-7800
- Fax
- (346) 215-1007
- NPI assigned
- Aug 27, 2019
- Last updated
- Jul 23, 2020
- 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
- Saeed S Mahboubi
- Title
- Cfo
- Phone
- (469) 341-7800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | NU | Primary |
Addresses
Primary practice location
2101 S Coulter St
Amarillo, TX 79106-2513
Mailing address
2101 S Coulter St
Amarillo, TX 79106-2513
Phone (469) 341-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1891343455. Details of each certification follow.
Hospital certification: CCN 670228
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- EXCEPTIONAL AMARILLO N COULTER
- Certification status
- Terminated Voluntary: merger or closure, May 11, 2023
- Provider type (POS)
- Hospital – Short-term
- Participating since
- May 8, 2020
- Last certification
- May 8, 2020
- Beds
- 1
- Ownership / control type
- Private (not for profit)
- Facility address
- 2101 S Coulter St
Amarillo, TX 79106
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1595462400000",
"number": "1891343455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 S COULTER ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062513",
"telephone_number": "469-341-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 S COULTER ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062513",
"telephone_number": "469-341-7800",
"fax_number": "346-215-1007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCEPTIONAL AMARILLO N COULTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-27",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A",
"authorized_official_last_name": "MAHBOUBI",
"authorized_official_first_name": "SAEED",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "469-341-7800"
},
"taxonomies": [
{
"code": "261QE0002X",
"taxonomy_group": "",
"desc": "Clinic/Center, Emergency Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
- Evelyn Archer Mdpa
- Bethany Everett, PHARMD
- Sheree Annette Evers, PTA
- Derek Allen Ewell, D.O.
- Rylee Jo Ewing, PHARMD
- Exceptional Amarillo S Coulter LLC
- Exceptional H C Amarillo LLC
- Exceptional Health Care Amarillo LLC (Amarillo Community Hospital)
- Exceptional Physicians Group Amarillo Hospital PLLC
- Exceptional Physicians Group Amarillo North PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.