| Shackelford County Community Resource Center | |
|
725 Pate St Albany TX 76430-3225 | |
| (325) 762-2447 | |
| (325) 762-2186 |
| Full Name | Shackelford County Community Resource Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 725 Pate St, Albany, Texas |
| Authorized Official Name and Position | Tina Louise Betcher (BILLING MANAGER/CREDENTIALER) |
| Authorized Official Contact | 3258934010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shackelford County Community Resource Center Po Box 2435 Albany TX 76430-8020 Ph: (325) 762-2447 | Shackelford County Community Resource Center 725 Pate St Albany TX 76430-3225 Ph: (325) 762-2447 |
| NPI Number | 1194804278 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 8628027174 |
|---|---|
| Medicare Enrollment ID | O20050121000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194804278 | NPI | - | NPPES |
| 287755701 | Medicaid | TX | |
| 171901503 | Medicaid | TX | |
| 171901504 | Medicaid | TX | |
| 171901505 | Medicaid | TX | |
| 214962701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 30117281979 (Texas) | Primary |
| Provider Name | Judith G Graves |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215037833 PECOS PAC ID: 6002704574 Enrollment ID: I20040306000217 |
| Provider Name | Cynthia A Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710093497 PECOS PAC ID: 7810957685 Enrollment ID: I20041015000365 |
| Provider Name | Alan K Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144283664 PECOS PAC ID: 8628012895 Enrollment ID: I20050617000778 |
| Provider Name | John Dale Crowley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053476135 PECOS PAC ID: 3173613775 Enrollment ID: I20071219000813 |
| Provider Name | Joanne C Paulk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700848850 PECOS PAC ID: 8123101805 Enrollment ID: I20080219000390 |
| Provider Name | Alosha L Hayes-long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669547568 PECOS PAC ID: 7113003526 Enrollment ID: I20080326000332 |
| Provider Name | Carol Lynn Copelin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669637831 PECOS PAC ID: 9234292442 Enrollment ID: I20090114000668 |
| Provider Name | Sherron L Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013995026 PECOS PAC ID: 7517022841 Enrollment ID: I20090219000403 |
| Provider Name | Jennifer V Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205160082 PECOS PAC ID: 0446398325 Enrollment ID: I20091113000209 |
| Provider Name | Diana Lee Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417293598 PECOS PAC ID: 1254456023 Enrollment ID: I20130827000281 |
| Provider Name | Michelle Escobedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588973721 PECOS PAC ID: 8224278833 Enrollment ID: I20140205001250 |
| Provider Name | Cortney Rachelle Berkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629447859 PECOS PAC ID: 3577868678 Enrollment ID: I20160229000384 |
| Provider Name | Shayla R Fine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710474242 PECOS PAC ID: 5991060873 Enrollment ID: I20180523002659 |
| Provider Name | Chelsea Michelle Dickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790329134 PECOS PAC ID: 7517390479 Enrollment ID: I20191206000492 |
| Provider Name | Tamryn Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457981458 PECOS PAC ID: 9133546823 Enrollment ID: I20200826001563 |
| Provider Name | Erica R Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649864034 PECOS PAC ID: 8729497359 Enrollment ID: I20210511001314 |
| Provider Name | Meagan Freeman Wheat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093365702 PECOS PAC ID: 6507259223 Enrollment ID: I20220201002723 |
| Provider Name | Kaitlyn Nicole Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124755905 PECOS PAC ID: 9234512443 Enrollment ID: I20220822001807 |
| Provider Name | Kimberly Ranee East |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235727876 PECOS PAC ID: 2365813979 Enrollment ID: I20230118002113 |
| Provider Name | Ricky Lee Vaughn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043829179 PECOS PAC ID: 6204284292 Enrollment ID: I20231202000151 |
| Provider Name | Shawnah Danell Bass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194914036 PECOS PAC ID: 8022469550 Enrollment ID: I20240109004773 |
| Provider Name | Pamela Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730570698 PECOS PAC ID: 8820441710 Enrollment ID: I20240126002292 |
| Provider Name | Nannette Marie Keith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104015064 PECOS PAC ID: 8628421443 Enrollment ID: I20240129002353 |
| Provider Name | Zachary Neal Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013290899 PECOS PAC ID: 3678917150 Enrollment ID: I20240223001176 |
| Provider Name | Kathryn Linette Cobb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962691915 PECOS PAC ID: 6507306636 Enrollment ID: I20240904002407 |
Shackelford County Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 450 Kenshalo St, Albany, TX 76430 Phone: 325-762-3661 Fax: 325-762-3859 | |
Shackelford County Rural Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 Kenshalo St., Albany, TX 76430 Phone: 325-762-3661 Fax: 325-762-3859 | |
Big Country Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 Kenshalo, Albany, TX 76430 Phone: 325-762-3661 Fax: 325-762-3859 |