Jasper County Urgent Care PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

JASPER COUNTY URGENT CARE PLLC

Practice address

494 Springhill St
Suite 100
Jasper, TX 75951-4922

Phone

(409) 224-3586

Fax

(409) 224-3637

NPI assigned

Apr 20, 2017

Organization subpart

No

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

• Reatha Jeannette Bradberry I, FNP

  • Nurse Practitioner
  • Orange, TX
  • NPI 1548219876

  TX

  Medicare reassignment Care Compare group NPD
• Danny Wayne Credeur, FNP-C

  • Family Nurse Practitioner
  • Port Arthur, TX
  • NPI 1962716233

  TX

  Medicare reassignment Care Compare group NPD
• Mackenzie Leigh Cucancic, RN

  • Family Nurse Practitioner
  • Jasper, TX
  • NPI 1336891449

  TX

  Medicare reassignment Care Compare group NPD
• Dianna Velicia Belaire, NP-C

  • Family Nurse Practitioner
  • Port Arthur, TX
  • NPI 1689038655

  TX

  Medicare reassignment NPD
• Colby Ryan Thibodeaux, FNP

  • Family Nurse Practitioner
  • Lake Charles, LA
  • NPI 1912539115
  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23344/brand/1/csg/1/fhir/r4

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

Authorized official

Name

Jacklyn Robinson

Title

Practice Manager

Phone

(409) 550-4198

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1972038503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 SPRINGHILL ST",
            "address_2": "SUITE 100",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514922",
            "telephone_number": "409-224-3586",
            "fax_number": "409-224-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 SPRINGHILL ST",
            "address_2": "SUITE 100",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514922",
            "telephone_number": "409-224-3586",
            "fax_number": "409-224-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER COUNTY URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JACKLYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "409-550-4198"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher H Hoyt, MD
• Hughes Medical Group
• David Scott Hughes, LCDC
• Jenna-Maree Inman, FNP-BC
• Jasper County Committee on Aging Inc
• Jasper Diagnostic Clinic
• Jasper Emergency Medicine Associates PA
• Jasper Emergency Physicians, PLLC
• Jasper Family Dental
• Jasper Family Eyecare PLLC

• All providers in Jasper, TX
• Urgent Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.