GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC (NPI# 1114985876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114985876 |
| Entity Type | Organization |
| Organization Name | GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC |
| Other Organization Name | GOOD SHEPHERD GLENN-GARRETT CLINIC - JEFFERSON |
| Practice Address |
903 N Walcott St Jefferson TX 75657-1128 |
| Mailing Address |
404 N Kaufman St Linden TX 75563-5234 |
| Practice Telephone | 9036659500 |
| Practice Fax Number | 9036659501 |
| Mailing Telephone | 9037565581 |
| Mailing Fax Number | 9037565005 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-07-26 |
| Authorized Official Name | MR. ED D BANOS (PRESIDENT) |
| Authorized Official Telephone | 9033151811 |
| Is Organization Subpart | Y |
| Parent Organization Name | GOOD SHEPHERD MEDICAL CENTER - LINDEN, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 130943706 | 05 | |
| RAILROAD MEDICARE | CP3371 | 01 | |
| SUPERIOR | 127650 | 01 | |
| BC BS OF TEXAS | 00H878 | 01 | |
| DME | 0504760001 | 01 |
| Other Name | Type Code |
|---|---|
| Good Shepherd Glenn-Garrett Clinic - Jefferson | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205894961 | Good Shepherd Medical Center - Linden, Inc | Clinic/Center | 402 N Kaufman, Linden, TX 75563-5234 | 2006-05-03 |
| 1811954993 | Good Shepherd Medical Center - Linden, Inc | Clinic/Center | 201 E. 2nd Street, Hughes Springs, TX 75656-2597 | 2006-05-01 |
| Street Address |
903 N WALCOTT ST |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205953130 | William Louis Castleman | Massage Therapist | 903 N Walcott St, Jefferson, TX 75657-1128 | 2007-03-24 |
| 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 |
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 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 |
| Find all providers in zip 75657 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1780664011 | Jefferson Family Health Center | Clinic/Center | 106 N Alley St, Jefferson, TX 75657-1408 | 2006-01-20 |
| 1598093239 | Phynet, Inc | Clinic/Center | 219 N Polk St, Jefferson, TX 75657-2131 | 2009-11-18 |
| 1427048172 | Ashe Memorial Hospital, Inc. | Clinic/Center | 200 Hospital Ave, Jefferson, NC 28640-9244 | 2005-10-25 |
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| 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.