EAST TEXAS MEDICAL CENTER HENDERSON (NPI# 1720212095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720212095 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER HENDERSON |
| Other Organization Name | ETMC SWING BED |
| Practice Address |
300 Wilson St Henderson TX 75652-5956 |
| Practice Telephone | 9036556567 |
| Mailing Telephone | 9036556567 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-06-30 |
| Authorized Official Name | MR. BYRON HALE (SR. VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 9035318010 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST TEXAS MEDICAL CENTER HENDERSON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | TX | Hospital Units |
| Other Name | Type Code |
|---|---|
| ETMC Swing Bed | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215164231 | East Texas Medical Center Henderson | General Acute Care Hospital | 300 Wilson, Henderson, TX 75652-5956 | 2009-06-17 |
| 1942437967 | East Texas Medical Center Henderson | General Acute Care Hospital | 300 Wilson St, Henderson, TX 75652-5956 | 2009-06-17 |
| 1083848352 | East Texas Medical Center Henderson | Nurse Anesthetist, Certified Registered | 300 Wilson St, Henderson, TX 75652-5956 | 2009-05-14 |
| 1376777649 | East Texas Medical Center Henderson | Clinic/Center | 300 Wilson St, Henderson, TX 75652-5956 | 2009-05-14 |
| 1245464536 | East Texas Medical Center Henderson | Clinic/Center | 300 Wilson St, Henderson, TX 75652-5956 | 2009-05-14 |
| 1770717167 | East Texas Medical Center Henderson | General Acute Care Hospital | 300 Wilson St, Henderson, TX 75652-5956 | 2009-05-13 |
| Street Address |
300 WILSON ST |
| City | HENDERSON |
| State | TX |
| Zip Code | 75652-5956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255954509 | Shawna Elizabeth Sharp | Nurse Practitioner | 300 Wilson St, Henderson, TX 75652-5956 | 2020-05-21 |
| 1053953794 | Mica Ladon Norman | Nurse Practitioner | 300 Wilson St, Henderson, TX 75652-5956 | 2019-10-15 |
| 1639670466 | Henderson Hospital, LLC | Nurse Anesthetist, Certified Registered | 300 Wilson St, Henderson, TX 75652-5956 | 2018-02-27 |
| 1043710437 | Henderson Hospital, LLC | Internal Medicine | 300 Wilson St, Henderson, TX 75652-5956 | 2018-02-13 |
| 1952800310 | Henderson Hospital, LLC | Clinic/Center | 300 Wilson St, Henderson, TX 75652-5956 | 2018-02-12 |
| 1326546797 | Henderson Hospital, LLC | General Acute Care Hospital | 300 Wilson St, Henderson, TX 75652-5956 | 2018-01-31 |
| 1154730273 | Tanager Emergency Physicians Pllc | Emergency Medicine | 300 Wilson St, Henderson, TX 75652-5956 | 2014-08-04 |
| 1376828400 | Kwabena Agyapong Osman | General Acute Care Hospital | 300 Wilson St, Henderson, TX 75652-5956 | 2011-10-20 |
| 1679899751 | Rusk Physician Services Pa | Hospitalist | 300 Wilson St, Henderson, TX 75652-5956 | 2010-04-14 |
| 1942437967 | East Texas Medical Center Henderson | General Acute Care Hospital | 300 Wilson St, Henderson, TX 75652-5956 | 2009-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184264384 | John Etakibuebu | Pharmacist | 2415 Hwy 79 S, Henderson, TX 75652 | 2020-01-15 |
| 1841758596 | Janet Juanita Ray | Registered Nurse | 1987 Fm 2276 N, Henderson, TX 75652 | 2019-03-12 |
| 1912490483 | Matthew Davis Acres | Dentist | 1910 Tx-43, Henderson, TX 75652 | 2018-06-11 |
| 1467863407 | Counseling Services | Counselor | 1103 Wilson Street, Henderson, TX 75652 | 2014-05-13 |
| 1285900852 | Linda June Pool | Music Therapist | 6861 Fm 1251 E., Henderson, TX 75652 | 2012-03-28 |
| 1780992586 | Furqueron & Jackson Dentistry Partnership | Dentist | 1910 State Hwy 43 East, Henderson, TX 75652 | 2010-09-15 |
| 1235396359 | Crystal Touchstone | Physical Therapy Assistant | 1010 W Main, Henderson, TX 75652 | 2008-05-16 |
| 1609082379 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 103 Truman, Henderson, TX 75652 | 2007-05-16 |
| 1790997302 | Billy George Brown | Dentist | 300-b North High Street, Henderson, TX 75652 | 2007-05-04 |
| 1043379761 | Donna G Mason-mcfalll | Counselor | 1103 Wilson St, Henderson, TX 75652 | 2006-12-08 |
| Find all providers in zip 75652 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447395322 | Henderson Memorial Hospital | Medicare Defined Swing Bed Unit | 300 Wilson St, Henderson, TX 75652-5956 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508214222 | Trinity Diagnostic Clinic, P.a | Medicare Defined Swing Bed Unit | 6324 Southern Hills Dr, Fort Worth, TX 76132-4485 | 2016-06-03 |
| 1710224647 | Caroline Chioma Ukachukwu | Medicare Defined Swing Bed Unit | 6565 Fannin St. Mgj. Suit 11, The Methodist Hospital, Mary Gibbs, Houston, TX 77030 | 2013-01-11 |
| 1023353752 | Eastland Memorial Hospital District | Medicare Defined Swing Bed Unit | 304 South Daugherty Street, Eastland, TX 76448 | 2012-12-06 |
| 1447574819 | Frio Hospital Association | Medicare Defined Swing Bed Unit | 200 S Ih 35, Pearsall, TX 78061-6601 | 2010-03-15 |
| 1952567588 | Preferred Hospital Leasing Junction, Inc | Medicare Defined Swing Bed Unit | 349 Reid Rd, Junction, TX 76849-3049 | 2008-08-04 |
| 1699939421 | Preferred Hospital Leasing Hemphill, Inc. | Medicare Defined Swing Bed Unit | 2301 State Highway 83w, Hemphill, TX 75948-0750 | 2008-07-10 |
| 1801087630 | Mitchell County Hospital District | Medicare Defined Swing Bed Unit | 997 West I-20, Colorado City, TX 79512 | 2007-08-07 |
| 1023138781 | Throckmorton County Memorial Hosp | Medicare Defined Swing Bed Unit | 802 N. Minter Ave., Throckmorton, TX 76483-5357 | 2007-03-29 |
| 1093839839 | Muenster Hospital District | Medicare Defined Swing Bed Unit | 605 N Maple, Muesnter, TX 76252-2424 | 2007-03-19 |
| 1841371739 | Jackson County Hospital District | Medicare Defined Swing Bed Unit | 1013 S Wells Street, Edna, TX 77957-4098 | 2006-10-18 |
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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.