NPIMap

Organization Active NPI

Glen Rose Medical Foundation

Doing business as Glen Rose Medical Center

  • Certified Registered Nurse Anesthetist
  • Glen Rose, TX
National Provider Identifier
1992749857
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
000059 Issued in TX
Legal business name
GLEN ROSE MEDICAL FOUNDATION
Doing business as
Glen Rose Medical Center
Practice address
1021 Holden St
Glen Rose, TX 76043-4937
Phone
(254) 897-2215
Fax
(254) 897-1446
NPI assigned
Jun 15, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Hal Mayo
Title
Cfo
Phone
(254) 897-2215

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 000059 TX
Emergency Medicine Physician 207P00000X 000059 TX
Certified Registered Nurse Anesthetist 367500000X 000059 TX Primary

Addresses

Primary practice location

1021 Holden St
Glen Rose, TX 76043-4937

Mailing address

PO Box 2099
Glen Rose, TX 76043-2099
Phone (254) 897-2215

Other identifiers 1

IdentifierTypeStateIssuer
0050KUOtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • GLEN ROSE MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glen Rose Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 98

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1992749857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2099",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760432099",
            "telephone_number": "254-897-2215",
            "fax_number": "254-897-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 HOLDEN ST",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434937",
            "telephone_number": "254-897-2215",
            "fax_number": "254-897-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ROSE MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "HAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "254-897-2215"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "000059",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "000059",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "000059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0050KU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLEN ROSE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Rose, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.