UTMB (NPI# 1497105084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497105084 |
| Entity Type | Organization |
| Organization Name | UTMB |
| Practice Address |
3060 Fm 3514 Medical Department - Ms. Adodo Beaumont TX 77705-7635 |
| Mailing Address |
3060 Fm 3514 Beaumont TX 77705-7635 |
| Practice Telephone | 4097225255 |
| Practice Fax Number | 4097194157 |
| Mailing Telephone | 4097225255 |
| Mailing Fax Number | 4097194157 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |
| Authorized Official Name | MARK BARBER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4097225255 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP131092 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831318781 | Utmb | Special Hospital | 515 1st St, #330, Galveston, TX 77550-5769 | 2007-04-25 |
| 1295281350 | Utmb | Clinic/Center | 301 University Blvd, Galveston, TX 77555-5302 | 2016-08-29 |
| 1811394208 | Utmb | Point of Service | 2350 Atascocita Rd, Humble, TX 77396-3503 | 2014-12-01 |
| 1568869063 | Utmb | General Acute Care Hospital | 301 University Blvd, Galveston, TX 77555-0587 | 2014-11-26 |
| 1487059077 | Utmb | Health Maintenance Organization | 1500 E Langdon Rd, Dallas, TX 75241-7136 | 2014-10-27 |
| 1063821981 | Utmb | Clinic/Center | 12603 Southwest Fwy Ste 335, Stafford, TX 77477-3842 | 2014-08-05 |
| 1386923670 | Utmb | General Acute Care Hospital | 301 University Blvd, Jsa 9.128. Dept of Neurology, Galveston, TX 77555-0539 | 2011-08-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UTMB | 301 University Blvd, Galveston, TX 77555-5302 |
| Street Address |
3060 FM 3514 MEDICAL DEPARTMENT - MS. ADODO |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77705-7635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932143351 | Emma Rachele Davis | Nurse Practitioner | 3060 Fm 3514, Beaumont, TX 77705 | 2006-06-15 |
| 1932625571 | George O Egesi | Nurse Practitioner | 3060 Fm 3514, Beaumont, TX 77705-7635 | 2017-08-15 |
| 1336493055 | Brendan Andrew Dunlap | Physician Assistant | 3060 Fm 3514, Beaumont, TX 77705-7635 | 2012-11-02 |
| 1992942569 | Diane R Wilhite | Psychologist | 3060 Fm 3514, Beaumont, TX 77705-7635 | 2009-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
| 1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
| 1326443391 | Scott Forbes | Psychologist | 6200 Knauth Rd, Beaumont, TX 77705 | 2014-11-03 |
| 1518367622 | Dennis Agricola | Nurse Practitioner | 6200 Knauth Road, Beaumont, TX 77705 | 2014-08-26 |
| 1639591480 | Chs Texas Medical, P.a. | General Practice | 11357 Highway 10 Sw, Smith Rd, Beaumont, TX 77705 | 2014-01-14 |
| 1649523309 | Tri-medical Emergency Medical Services Lp | Ambulance | 4610 St. Louis St, Beaumont, TX 77705 | 2012-10-18 |
| 1437462785 | Cynthia Ksiazek | Social Worker | 857 E Virginia, Beaumont, TX 77705 | 2010-07-15 |
| 1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
| 1588811731 | Prasad L Surapaneni | Family Medicine | 5430 Knauth Rd, Beaumont, TX 77705 | 2008-08-19 |
| 1891994612 | Jennifer Lien Truong | Occupational Therapist | 4205 Grandberry, Beaumont, TX 77705 | 2007-07-12 |
| Find all providers in zip 77705 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437614641 | Matthew Carter | Nurse Practitioner | 3030 North St Ste 460, Beaumont, TX 77702-1499 | 2019-02-01 |
| 1598272338 | Kare Infusion Center LLC | Nurse Practitioner | 6755 Phelan Blvd Ste 46, Beaumont, TX 77706-6077 | 2018-01-02 |
| 1407108715 | Garrett Benjamin Roy | Nurse Practitioner | 4347 Phelan Blvd Ste 101, Beaumont, TX 77707-2159 | 2012-10-10 |
| 1629328919 | Leslie F Anslem | Nurse Practitioner | 3080 College St., Beaumont, TX 77701-4606 | 2012-09-13 |
| 1003976531 | Lynda Marie Few | Nurse Practitioner | 3560 Delaware St # 601, Beaumont, TX 77706-3067 | 2006-12-12 |
| 1073525697 | Connie L Brown | Nurse Practitioner | 155 Ih-10 North, Ste: 1, Beaumont, TX 77707 | 2006-08-12 |
| 1508894528 | Tammy L Stout | Nurse Practitioner | 3406 College St # 100, Beaumont, TX 77701-4612 | 2006-06-29 |
| 1407884844 | Susan J Lundy | Nurse Practitioner | 3430 Fannin St, Beaumont, TX 77701-3803 | 2006-06-28 |
| 1932143351 | Emma Rachele Davis | Nurse Practitioner | 3060 Fm 3514, Beaumont, TX 77705 | 2006-06-15 |
| 1578513040 | Shawn Rooney Gray | Nurse Practitioner | 857 E. Virginia, Beaumont, TX 77705 | 2006-05-12 |
| Find all providers in BEAUMONT | ||||
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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.