PHYNET, INC (NPI# 1023275096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023275096 |
| Entity Type | Organization |
| Organization Name | PHYNET, INC |
| Other Organization Name | JEFFERSON LIFE CENTER |
| Practice Address |
219 N Polk St Jefferson TX 75657-2131 |
| Mailing Address |
4002 Technology Ctr Longview TX 75605-2697 |
| Practice Telephone | 9036652600 |
| Practice Fax Number | 9036652608 |
| Mailing Telephone | 9032470484 |
| Mailing Fax Number | 9032470485 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2010-07-14 |
| Authorized Official Name | JOHN D. FORD (PRESIDENT) |
| Authorized Official Telephone | 9032470484 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHYNET INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 159694201 | 05 |
| Other Name | Type Code |
|---|---|
| Jefferson Life Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225295298 | Phynet, Inc | Clinic/Center | 800 N Hill St, Tatum, TX 75691-1740 | 2008-05-19 |
| 1700105129 | Phynet, Inc | Clinic/Center | 800 N Hill St, Tatum, TX 75691-1740 | 2010-05-25 |
| 1114240587 | Phynet, Inc | Home Health | 4002 Technology Ctr, Longview, TX 75605-2697 | 2010-03-12 |
| 1558684944 | Phynet, Inc | Clinic/Center | 4002 Technology Ctr, Longview, TX 75605-2697 | 2010-03-12 |
| 1669701546 | Phynet, Inc | Clinic/Center | 123 N Main St, Lone Star, TX 75668-2223 | 2009-12-23 |
| 1669700233 | Phynet, Inc | Clinic/Center | 106 E Gilmer St, Big Sandy, TX 75755-2129 | 2009-11-19 |
| 1598093239 | Phynet, Inc | Clinic/Center | 219 N Polk St, Jefferson, TX 75657-2131 | 2009-11-18 |
| 1548437759 | Phynet, Inc | Clinic/Center | 106 E Gilmer St, Big Sandy, TX 75755-2129 | 2008-05-15 |
| Street Address |
219 N POLK ST |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657-2131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 1598093239 | Phynet, Inc | Clinic/Center | 219 N Polk St, Jefferson, TX 75657-2131 | 2009-11-18 |
| 1841523917 | Marshall Physical Therapy, Inc | Physical Medicine & Rehabilitation | 219 N Polk St, Jefferson, TX 75657-2131 | 2009-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131995 | Kimberly George | Case Manager/Care Coordinator | 261 Ma County Road 3430, Jefferson, TX 75657 | 2016-09-06 |
| 1124116561 | The Med Shop | Durable Medical Equipment & Medical Supplies | 110 N . Walnut, Jefferson, TX 75657 | 2006-10-11 |
| 1487644068 | Denise Sepulvado Norris | Occupational Therapist | 1404 Marion County Road 3509, Jefferson, TX 75657 | 2005-10-25 |
| 1700072477 | James Leo Carroll | Physical Therapy Assistant | 339 Tangiers, Jefferson, TX 75657-0598 | 2007-09-17 |
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1124495486 | Fannin County Hospital Authority | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2015-08-21 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| 1558404293 | Jefferson Isd | Local Education Agency (LEA) | 1600 Martin Luther King Dr, Jefferson, TX 75657-1061 | 2007-02-14 |
| 1730352667 | Demetria Rena Parker | Nurse's Aide | 506 E Harrison St, Jefferson, TX 75657-1106 | 2008-04-11 |
| 1114985876 | Good Shepherd Medical Center - Linden, Inc | Clinic/Center | 903 N Walcott St, Jefferson, TX 75657-1128 | 2006-05-03 |
| Find all providers in zip 75657 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1104078641 | Concentra Health Services, Inc. | Clinic/Center | 4015 Jefferson Highway, Jefferson, LA 70121-1629 | 2008-10-15 |
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| 1417570003 | Desire To Live Now, LLC | Clinic/Center | 1409 N Bishop St # A4, San Marcos, TX 78666-2600 | 2020-05-18 |
| 1255951679 | Sedrick Dewayne Bunton | Clinic/Center | 2923 Havenwood Ct, Richmond, TX 77406-2091 | 2020-04-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.