Northwest Texas Healthcare System, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NORTHWEST TEXAS HEALTHCARE SYSTEM, INC

Practice address

814 Martin Rd
Amarillo, TX 79107-6814

Phone

(806) 468-4390

Fax

(806) 342-4789

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Mark A Miracle, MBA

Title

Chief Operating Officer

Phone

(806) 468-4390

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Women's and Children's Healthcare Center Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northwest Texas Healthcare System Inc

  • Other Specialist/Technologist
  • Amarillo, TX
  • NPI 1154347987

  O20040123000725

  Same enrollment

Practitioners 1

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

• Sivaram Sudhakar, M.D.

  • Neurology Physician
  • Amarillo, TX
  • NPI 1497844112
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1962434860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9633",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791059633",
            "telephone_number": "806-354-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 MARTIN RD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791076814",
            "telephone_number": "806-468-4390",
            "fax_number": "806-342-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST TEXAS HEALTHCARE SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "MIRACLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "806-468-4390",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137245005",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Women's and Children's Healthcare Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Women's and Children's Healthcare Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Northwest Texas Healthcare System Inc
• Northwest Texas Healthcare System Inc
• Northwest Texas Healthcare System Inc
• Northwest Texas Healthcare System Inc
• Northwest Texas Healthcare System Inc
• Northwest Texas Healthcare System, Inc.
• Northwest Texas Physician Group
• Northwest Texas Spine Center LLC
• Northwest Texas Surgical Hospital, LLC
• Northwest Texas Surgical Hospital, LLC

• Multi-Specialty Clinic/Center in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.