Ebd Bemc Rockwall LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

EBD BEMC ROCKWALL LLC

Practice address

1975 Alpha Dr
Suite 100
Rockwall, TX 75087-4951

Phone

(214) 294-6200

Fax

(713) 637-1305

NPI assigned

Dec 5, 2013

Organization subpart

No

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

Authorized official

Name

John Eric BuckNPI 1053383604

Title

President

Phone

(936) 441-0674

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 3

• Baylor Emergency Medical Center Doing business as
• Baylor Emergency Medical Center Rockwall Doing business as
• Baylor Scott & White Emergency Hospital Rockwall Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 670097

Legal name

BAYLOR EMERGENCY MEDICAL CENTER

Certification status

Terminated Voluntary: merger or closure, Apr 11, 2018

Provider type (POS)

Hospital – Short-term

Participating since

Oct 1, 2014

Last certification

Aug 2, 2017

Beds

8

Ownership / control type

Private (for profit)

Facility address

1975 Alpha Ste 100
Rockwall, TX 75087

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Eric Buck, M.D.

  • Emergency Medicine Physician
  • Conroe, TX
  • NPI 1053383604
  NPD (past) Authorized official

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1952732653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8686 NEW TRAILS DR",
            "address_2": "SUITE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773811176",
            "telephone_number": "713-637-1144",
            "fax_number": "281-292-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 ALPHA DR",
            "address_2": "SUITE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874951",
            "telephone_number": "214-294-6200",
            "fax_number": "713-637-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBD BEMC ROCKWALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-05",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-441-0674"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343799801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Emergency Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Emergency Medical Center Rockwall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Emergency Hospital Rockwall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Dwyer, PSYD, MA, MS
• Amber Denise Dyer, LVN
• Macie Leigh Eastep
• Eastland Memorial Hospital District
• Amy Brazda Eastman, MD
• Megan Ebeier, COTA
• Joy Akudo Ebo, PHARMD
• Benjamin Ebozue
• Maite Echeandia
• Edward P Hurst MD PA

• General Acute Care Hospital in Rockwall, TX
• Providers in Rockwall, TX by specialty
• General Acute Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.

Verify at the official NPI Registry.