EAST TEXAS MEDICAL CENTER JACKSONVILLE (NPI# 1285689133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285689133 |
Entity Type | Organization |
Organization Name | EAST TEXAS MEDICAL CENTER JACKSONVILLE |
Practice Address |
501 S Ragsdale St Jacksonville TX 75766-2467 |
Practice Telephone | 9035415000 |
Practice Fax Number | 9035415067 |
Mailing Telephone | 9035415000 |
Mailing Fax Number | 9035415067 |
Enumeration Date | 2006-05-22 |
Last Update Date | 2010-12-02 |
Authorized Official Name | MR. JACK R ENDRES (ADMINISTRATOR) |
Authorized Official Telephone | 9035415000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 282N00000X | General Acute Care Hospital | 000416 | TX | Hospitals |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BCBS PROVIDER NUMBER | 00J11A | 01 |
TX | BCBS PROVIDER NUMBER | HH0170 | 01 |
TX | 130612806 | 05 | |
TX | 201848301 | 05 | |
TX | 130612801 | 05 | |
TX | 130612804 | 05 | |
TX | DBA ETMC FIRST PHYSICIANS CLINIC RUSK | 1972827822 | 01 |
TX | DBA ETMC FIRST PHYSICIANS CLINIC FRANKSTON | 1023342755 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023342755 | East Texas Medical Center Jacksonville | Clinic/Center | 580 North Frankston Highway, Frankston, TX 75763-2654 | 2009-09-29 |
1821366170 | East Texas Medical Center Jacksonville | Clinic/Center | 203 Nacogdoches St, Suite 280, Jacksonville, TX 75766-2444 | 2011-12-01 |
1972827822 | East Texas Medical Center Jacksonville | Clinic/Center | 1325 N Dickinson Dr, Rusk, TX 75785-1051 | 2010-03-22 |
Street Address |
501 S RAGSDALE ST |
City | JACKSONVILLE |
State | TX |
Zip Code | 75766-2467 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982692869 | Tri-county Anesthesia Associates, Pa | Nurse Anesthetist, Certified Registered | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2005-10-13 |
1306346796 | Jacksonville Hospital LLC | Internal Medicine | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-02-13 |
1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
1699928069 | Daniel C. Bennett Md Pa | Radiology | 501 S Ragsdale St, Etmc Jacksonville Radiology Department, Jacksonville, TX 75766-2434 | 2008-10-29 |
1497934319 | Paul Alan Hobus Md Pa | Anesthesiology | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2007-10-26 |
1831275296 | Paul Alan Hobus | Anesthesiology | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2006-10-28 |
1639280795 | Todd Campbell Md Pa | Radiology | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2006-08-31 |
1477575660 | David Newsom | Nurse Anesthetist, Certified Registered | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2006-07-24 |
1669416467 | Donald Victor Mcgraw | Family Medicine | 501 S Ragsdale St, Jacksonville, TX 75766-2467 | 2006-06-15 |
1114967577 | Cherokee Emergency Medicine Associates Pa | Physician Assistant | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2006-06-07 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770062788 | David Rentz | Occupational Therapy Assistant | 838 Brown St., Jacksonville, TX 75766 | 2018-08-09 |
1295233146 | Amanda Dawn Anderson | Licensed Vocational Nurse | Fm 347, Jacksonville, TX 75766 | 2018-01-25 |
1467896241 | Christopher Mark Sirianni | Anesthesiology | 2026 S Jackson St Apt 1213, Jacksonville, TX 75766 | 2013-04-23 |
1164703047 | Aegis Psychological Consulting LLC | Psychologist | 208 E. Rusk St., Jacksonville, TX 75766 | 2011-09-06 |
1952697872 | Melissa Springmeyer | Family Medicine | 2026 South Jacksonville Street, Jacksonville, TX 75766 | 2011-06-20 |
1306031018 | Michael Kay Moore | Occupational Therapist | 4155 Cr 3908, Jacksonville, TX 75766 | 2007-09-06 |
1730398827 | Cherokee County Health Department | Public Health or Welfare | 510 East Commerce, Jacksonville, TX 75766 | 2007-05-22 |
1568689545 | Mary Alice Bone | Preventive Medicine | 510 E. Commerce, Jacksonville, TX 75766 | 2007-04-19 |
1619093176 | Assisted Living Concepts Inc | Assisted Living Facility | 211 Phillip Street, Jacksonville, TX 75766 | 2007-03-22 |
1265560767 | Anderson Cherokee Community Enrichment Services | Counselor | 1011 College Ave, Jacksonville, TX 75766 | 2007-02-28 |
Find all providers in zip 75766 |
Taxonomy Code | 282N00000X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
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1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
1922487974 | Shemaka James | General Acute Care Hospital | 5202 Wabash Blvd, Jacksonville, FL 32254-1366 | 2015-05-22 |
1962893149 | Michelle Porter | General Acute Care Hospital | 402 Stagecoach Dr, Jacksonville, NC 28546-8663 | 2015-02-10 |
1811246390 | St. Vincent's Healthcare | General Acute Care Hospital | 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 | 2012-08-30 |
1255570974 | Svila Skin Solutions | General Acute Care Hospital | 1936 San Marco Blvd, Jacksonville, FL 32207-3286 | 2009-02-19 |
1760644009 | Walter Ruday Jr. | General Acute Care Hospital | 2748 University Blvd W, Jacksonville, FL 32217-2123 | 2008-06-27 |
1386801116 | Abdolreza Mohammadian | General Acute Care Hospital | 1536 N.jefferson Street, Va Outpatient Clinic, Jacksonville, FL 32209-0000 | 2008-05-20 |
1861451114 | Allegiance Hospital of North Little Rock, LLC | General Acute Care Hospital | 1400 Braden St., Jacksonville, AR 72076 | 2006-03-23 |
1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
1144735069 | Brynn Marr Hospital - Navy Resource Sharing | General Acute Care Hospital | 192 Village Dr, Jacksonville, NC 28546-7238 | 2017-12-14 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 75766 |
Please comment or provide details below to improve the information on EAST TEXAS MEDICAL CENTER JACKSONVILLE.
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.