TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION (NPI# 1154380152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154380152 |
| Entity Type | Organization |
| Organization Name | TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION |
| Practice Address |
901 Wallace Blvd Building 501 Amarillo TX 79106-1705 |
| Practice Telephone | 8063513200 |
| Practice Fax Number | 8063513344 |
| Mailing Telephone | 8063513200 |
| Mailing Fax Number | 8063513344 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2020-09-29 |
| Authorized Official Name | MELLISA TALLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8063513206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 127378102 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013362169 | Texas Panhandle Mental Health Mental Retardation | Clinic/Center | 2002 Hardy St, Amarillo, TX 79106-2102 | 2016-04-26 |
| 1104206853 | Texas Panhandle Mental Health Mental Retardation | Clinic/Center | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2015-06-08 |
| 1740300631 | Texas Panhandle Mental Health Mental Retardation | Clinic/Center | 1703 S Avondale St, Amarillo, TX 79106-4516 | 2007-04-02 |
| 1760555619 | Texas Panhandle Mental Health Mental Retardation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2006-11-16 |
| 1356300354 | Texas Panhandle Mental Health Mental Retardation | Psychiatry & Neurology | 901 Wallace Blvd, Building 501, Amarillo, TX 79106-1705 | 2006-03-20 |
| 1134188139 | Texas Panhandle Mental Health Mental Retardation | Social Worker | 901 Wallace Blvd, Building 501, Amarillo, TX 79106-1705 | 2006-03-20 |
| 1245299247 | Texas Panhandle Mental Health Mental Retardation | Counselor | 901 Wallace Blvd, Building 501, Amarillo, TX 79106-1705 | 2006-03-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION | 901 Wallace Blvd, Amarillo, TX 79106-1705 |
| Street Address |
901 WALLACE BLVD BUILDING 501 |
| City | AMARILLO |
| State | TX |
| Zip Code | 79106-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900101 | Texas Panhandle Mhmr | Case Management | 901 Wallace Blvd, Bldg 501, Amarillo, TX 79106-1705 | 2005-05-23 |
| 1265076558 | Jennifer Mckay | Counselor | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2019-10-30 |
| 1285101907 | Halzie Wingo | Speech-Language Pathologist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2018-10-31 |
| 1447774310 | Jordan Michelle Craig | Physical Therapist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2017-08-01 |
| 1821512989 | Doris Elena Ironfield | Speech-Language Pathologist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2017-07-31 |
| 1912454133 | Sydney Kidwell | Speech-Language Pathologist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2016-09-06 |
| 1104206853 | Texas Panhandle Mental Health Mental Retardation | Clinic/Center | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2015-06-08 |
| 1306195623 | Anna Barraza-derda | Speech-Language Pathologist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2012-08-31 |
| 1487919387 | Deborah Mueffelmann Collins | Speech-Language Pathologist | 901 Wallace Blvd, Amarillo, TX 79106-1705 | 2012-07-08 |
| 1750550125 | Barbara G London | Counselor | 901 Wallace Blvd, Bldg. 501, Amarillo, TX 79106-1705 | 2008-02-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773205 | Nisha Patel | Pharmacist | 1600 S Western Street, Amarillo, TX 79106 | 2020-09-01 |
| 1043851769 | Diana Moore | Pharmacist | 6010 Amarillo Blvd W (119), Amarillo, TX 79106 | 2019-10-03 |
| 1164988127 | Wade Family Services Pllc | Counselor | 1901 Medi Park Dr Suite 130, Amarillo, TX 79106 | 2019-02-14 |
| 1255802963 | Jennifer Cockrum | Hospitalist | Bsa Hospitalist, 1600 Wallace Blvd., Amarillo, TX 79106 | 2018-12-07 |
| 1346736691 | Denise Mills Donnell | Social Worker | 6010 Amarillo Bouldevard West Clc-b, Amarillo, TX 79106 | 2018-07-10 |
| 1124525472 | Abigail Batson | Student in an Organized Health Care Education/Training Program | 1400 S Coulter Street, Suite 1500, Amarillo, TX 79106 | 2018-04-11 |
| 1053812743 | Moc Amarillo, LLC | Skilled Nursing Facility | 1540 Research St., Amarillo, TX 79106 | 2018-02-27 |
| 1013459437 | Larry G. Schulz | Durable Medical Equipment & Medical Supplies | 1901 Medi Park Dr Ste 219, Amarillo, TX 79106 | 2016-11-16 |
| 1922453315 | Omar Saeed M Alzhrani | Student in an Organized Health Care Education/Training Program | 1400 S. Coulter - Suite 5100, Amarillo, TX 79106 | 2016-05-04 |
| 1972967529 | David Wayne Hohon | Internal Medicine | Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 | 2016-04-11 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235544503 | Kristen Leopard | Case Manager/Care Coordinator | 1904 Howard Dr Apt 4, Amarillo, TX 79106-2485 | 2014-06-25 |
| 1437574639 | Amarillo Ufirst Urgent Care Clinic Inc. | Case Manager/Care Coordinator | 201 Westgate Pkwy Unit A, Amarillo, TX 79121-1109 | 2014-02-25 |
| 1770661050 | Region 16 Education Service Center | Case Manager/Care Coordinator | 5800 Bell St, Amarillo, TX 79109-6230 | 2006-11-02 |
| 1174643860 | Apryl Dawn Mendoza | Case Manager/Care Coordinator | 17 Care Cir, Amarillo, TX 79124-2105 | 2007-03-29 |
| 1225097223 | Texas Panhandle Mhmr | Case Manager/Care Coordinator | 901 Wallace Blvd, Building 501, Amarillo, TX 79106-1705 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911644 | Ramiro Meave Jr. | Case Manager/Care Coordinator | 6162 Misty Meadow Rd Apt 1102, Corpus Christi, TX 78414-2570 | 2020-10-31 |
| 1992305999 | Jonah Micah Reyes | Case Manager/Care Coordinator | 94 Briggs St Ste 450, San Antonio, TX 78224-1294 | 2020-10-28 |
| 1285233668 | Patricia A Griffith | Case Manager/Care Coordinator | 203 Brewer St, Navasota, TX 77868-3603 | 2020-10-18 |
| 1699380881 | Margarita Williams | Case Manager/Care Coordinator | 111 W Anderson Ln # D202-b, Austin, TX 78752-1132 | 2020-09-14 |
| 1497360945 | Chosen Care, Inc. | Case Manager/Care Coordinator | 144 Clemens Ave, New Braunfels, TX 78130-5613 | 2020-09-11 |
| 1306451828 | Dorneisia Tyson | Case Manager/Care Coordinator | 320 E Wintergreen Rd Apt 20h, Desoto, TX 75115-2473 | 2020-09-11 |
| 1548874332 | Alicia Pery | Case Manager/Care Coordinator | 5997 Shady Oaks Dr, Frisco, TX 75034-7228 | 2020-08-31 |
| 1265045694 | Dimide Inc. | Case Manager/Care Coordinator | 1928 Transcendence Dr, St Paul, TX 75098-0900 | 2020-08-25 |
| 1326658261 | Jasmine Capers | Case Manager/Care Coordinator | 5700 N Knoll Apt 201, San Antonio, TX 78240-2253 | 2020-08-05 |
| 1588272876 | Avarita Shari Henry | Case Manager/Care Coordinator | 3710 Iris Ridge Way, Fresno, TX 77545-6040 | 2020-07-22 |
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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.