ANCOR HEALTH CENTER, PA (NPI# 1952946428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952946428 |
| Entity Type | Organization |
| Organization Name | ANCOR HEALTH CENTER, PA |
| Other Organization Name | SHINING STAR PEDIATRICS |
| Practice Address |
2304 Judson Rd Ste D Longview TX 75605-4675 |
| Practice Telephone | 9032126060 |
| Practice Fax Number | 9032124466 |
| Mailing Telephone | 9032126060 |
| Mailing Fax Number | 9032124466 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2019-11-14 |
| Authorized Official Name | EARLENE COOK (OFFICE MANAGER) |
| Authorized Official Telephone | 9039858110 |
| Is Organization Subpart | Y |
| Parent Organization Name | ANCOR HEALTH CENTER PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| SHINING STAR PEDIATRICS | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2403 Judson Rd Ste D, Longview, TX 756054639 | 9032126060 | 9032124466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992887384 | Ancor Health Center, Pa | Specialist | 818 N 4th St, Longview, TX 75601-5433 | 2006-10-19 |
| Street Address |
2304 JUDSON RD STE D |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75605-4675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851249 | Christopher E Ihionkhan | Pediatrics | 2304 Judson Rd Ste D, Longview, TX 75605-4675 | 2005-06-17 |
| 1669976528 | Kristi B Bagnell | Pediatrics | 2304 Judson Rd Ste D, Longview, TX 75605-4675 | 2018-03-23 |
| 1841444692 | Kristi Bengtson Bagnell | Pediatrics | 2304 Judson Rd Ste D, Longview, TX 75605-4675 | 2008-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
| 1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
| 1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
| 1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
| 1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
| 1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
| 1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
| 1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
| Find all providers in zip 75605 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740633650 | Joshua St.germain | Specialist | 404 Quail Ln, Longview, WA 98632-9278 | 2016-07-14 |
| 1750753513 | Elle's Essential Massage | Specialist | 803 Vandercook Way, Ste 2, Longview, WA 98632-4057 | 2015-10-20 |
| 1013276906 | Ellen A Rochon | Specialist | 820 Ocean Beach Hwy Ste 116, Longview, WA 98632-4081 | 2012-05-11 |
| 1134490667 | Mason Minton | Specialist | 1151 Commerce Ave, Longview, WA 98632-3024 | 2012-01-13 |
| 1356644009 | Katherine Rose Beaton | Specialist | 1815 Hudson Street, Longview, WA 98632 | 2010-12-17 |
| 1942510524 | Delanie Marie Crawford | Specialist | 1146 Commerce, Longview, WA 98632 | 2010-10-15 |
| 1972709889 | Rufus Dwayne Bowie IIi | Specialist | 2323 Armond Dr, Longview, TX 75602-3625 | 2007-06-26 |
| 1245432384 | Carolyn L O'brien | Specialist | 3318 Virgina Way, Longview, WA 98632 | 2007-06-01 |
| 1083834410 | Pavel Maslennikov | Specialist | 1151 Commerce Ave., Longview, WA 98632 | 2007-04-26 |
| 1871711267 | East Texas Allergy & Asthma Associates | Specialist | 1009 N 4th St Ste A, Longview, TX 75601-4768 | 2007-04-23 |
| Find all providers in LONGVIEW | ||||
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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.