NPIMap

Organization Active NPI

Shannon Medical Center

  • Children's Chronic Disease Hospital
  • San Angelo, TX
National Provider Identifier
1992765663
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Chronic Disease HospitalTaxonomy code 281PC2000X
Legal business name
SHANNON MEDICAL CENTER
Practice address
120 E Harris Ave
San Angelo, TX 76903-5904
Phone
(325) 657-5031
NPI assigned
Mar 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Miss Patricia Kirkham
Title
Billing Supervisor
Phone
(325) 657-5031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Chronic Disease Hospital 281PC2000X Primary

Addresses

Primary practice location

120 E Harris Ave
San Angelo, TX 76903-5904

Mailing address

PO Box 1879
San Angelo, TX 76902-1879
Phone (325) 657-5031

Other identifiers 2

IdentifierTypeStateIssuer
137226011MedicaidTX
094720202MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Karen G Rightmire MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1992765663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1879",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769021879",
            "telephone_number": "325-657-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904",
            "telephone_number": "325-657-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-25",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "325-657-5031",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "281PC2000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137226011",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094720202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.