CHRISTUS GOOD SHEPHERD MEDICAL CENTER – Anesthesiology Physician, NPI 1760908404
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CHRISTUS GOOD SHEPHERD MEDICAL CENTER
323 E Hawkins Pkwy Ste D
Longview, TX 756058165
Phone: (903) 544-6700
Fax: (903) 544-6735
Type: Location
323 E Hawkins Pkwy Ste E
Longview, TX 756058166
Phone: (903) 544-6700
Fax: (903) 544-6735
Type: Location
703 E Marshall Ave Ste 2000
Longview, TX 756015500
Phone: (903) 315-5300
Type: Location
1612 S Henderson Blvd
Kilgore, TX 756623518
Phone: (903) 983-2492
Fax: (903) 984-5367
Type: Location
700 E Marshall Ave
Longview, TX 756015580
Phone: (903) 315-2000
Type: Location
CHRISTUS Good Shepherd Medical Center - Marshall, 811, South Washington Avenue, Marshall, Harrison County, Texas, 75670, United States
MARSHALL, TX 756705336
Phone: (903) 927-6000
Fax: (903) 927-6101
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (987 days ago).
Enrollment records
1
Earliest due date
2023-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040604000400 | O | Clinic/Group Practice | TX | 2023-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75605)
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