CEDAR CREEK PSYCHIATRY, LLC (NPI# 1356866701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356866701 |
| Entity Type | Organization |
| Organization Name | CEDAR CREEK PSYCHIATRY, LLC |
| Practice Address |
700 S Palestine St Athens TX 75751-3325 |
| Mailing Address |
Po Box 118 Eustace TX 75124-0118 |
| Practice Telephone | 9032628292 |
| Practice Fax Number | 9036759577 |
| Mailing Telephone | 9032628292 |
| Mailing Fax Number | 9036759577 |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-08-07 |
| Authorized Official Name | LINDA HAYES (CEO) |
| Authorized Official Telephone | 9032628292 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP100127 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
700 S PALESTINE ST |
| City | ATHENS |
| State | TX |
| Zip Code | 75751-3325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720057029 | Carol Mae Mantooth | Counselor | 700 S Palestine St, Athens, TX 75751-3325 | 2006-03-17 |
| 1831797794 | Dawn Marie Lowe | Psychologist | 700 S Palestine St, Athens, TX 75751-3342 | 2020-10-13 |
| 1053931014 | Robert Craig Nicks | Psychologist | 700 S Palestine St, Athens, TX 75751-3342 | 2020-04-20 |
| 1477059673 | Curtis Ray Pickle | Counselor | 700 S Palestine St, Athens, TX 75751-3325 | 2018-04-05 |
| 1578968632 | Linda Hayes | Nurse Practitioner | 700 S Palestine St, Athens, TX 75751-3325 | 2014-10-30 |
| 1275962409 | Manda Herring | Social Worker | 700 S Palestine St, Athens, TX 75751-3325 | 2013-11-07 |
| 1215362470 | Donna Elaine Parks | Counselor | 700 S Palestine St, Athens, TX 75751-3325 | 2013-09-06 |
| 1093029951 | East Texas Psychological Services, Pllc | Psychologist | 700 S Palestine St, Athens, TX 75751-3325 | 2010-08-03 |
| 1588846034 | Etpns | Psychologist | 700 S Palestine St, Athens, TX 75751-3325 | 2007-11-27 |
| 1891989216 | Lisa Anne Jesionek | Hearing Instrument Specialist | 700 S Palestine St, Athens, TX 75751-3325 | 2007-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700414810 | Morghan Jungman | Physical Therapy Assistant | 6444 South Palestine St, Athens, TX 75751 | 2020-04-01 |
| 1497313340 | Rebecca Lynne Moehlenbrock | Physical Therapy Assistant | 711 Lucas Dr., Athens, TX 75751 | 2019-06-04 |
| 1013487669 | Jammie Jae Chaney | Licensed Vocational Nurse | 207 Colonial Circle, Athens, TX 75751 | 2018-11-27 |
| 1215423397 | Valarie M Chambless | Registered Nurse | 1505 Hwy. 19 South, Athens, TX 75751 | 2018-07-02 |
| 1609378181 | Jennifer Lynn Griffith | Occupational Therapist | 907 S Palenstine St., Athens, TX 75751 | 2018-03-01 |
| 1285931832 | Leonard J Barbarisi | Surgery | 6444 S Palestine, Athens, TX 75751 | 2011-02-17 |
| 1801123104 | Paul J Michiels | Family Medicine | 5313 Fm 2494, Athens, TX 75751 | 2009-11-06 |
| 1851527550 | Jordan Risinger | Dentist | 800 S. Palestine St., Athens, TX 75751 | 2009-06-08 |
| 1306005798 | Shawn Tai | Internal Medicine | 115 Medical Cir Ste 106, Athens, TX 75751 | 2008-06-02 |
| 1083730683 | Assisted Living Concepts Inc | Assisted Living Facility | 213 Cayuga Drive, Athens, TX 75751 | 2007-03-22 |
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| 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 |
|---|---|---|---|---|
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1861982993 | Sarah Standard Lockwood | Nurse Practitioner | 210 Lexington Cir, Athens, GA 30605-4991 | 2018-05-15 |
| 1447798616 | Kristy Leanne Williams | Nurse Practitioner | 101 Fitness Way Ste 1200, Athens, AL 35611-2492 | 2017-02-07 |
| 1790959708 | Bertha Stauff | Nurse Practitioner | 700 Sunset Drive Suite 504, Athens, GA 30606 | 2008-04-22 |
| 1295906634 | Wendy Lynn Prince | Nurse Practitioner | 725 W Market St Ste B, Athens, AL 35611-2456 | 2008-03-13 |
| 1386868768 | Holly Collier | Nurse Practitioner | 1088 Baxter St Ste A, Athens, GA 30606-6316 | 2007-04-13 |
| 1467552315 | Margaret A. Tonkovich | Nurse Practitioner | 542 W Union St Ste B, Athens, OH 45701-8300 | 2006-09-22 |
| 1073526547 | Benna Ellis Cunningham | Nurse Practitioner | 370 River Road, Athens, GA 30602-1755 | 2006-08-14 |
| 1871502732 | Cynthia Nixon | Nurse Practitioner | 704 S Palestine St, Athens, TX 75751-3325 | 2006-08-07 |
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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.