SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER (NPI# 1417248824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417248824 |
| Entity Type | Organization |
| Organization Name | SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER |
| Other Organization Name | RESOURCECARE BRECKENRIDGE |
| Practice Address |
2802 W Walker St Breckenridge TX 76424-4000 |
| Mailing Address |
Po Box 2435 Albany TX 76430-8020 |
| Practice Telephone | 2545597215 |
| Practice Fax Number | 2545597213 |
| Mailing Telephone | 3257622447 |
| Mailing Fax Number | 3257622186 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2012-10-12 |
| Authorized Official Name | MRS. TINA LOUISE BETCHER (BILLING MANAGER/CREDENTIALER) |
| Authorized Official Telephone | 3258934010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
30117281979 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 171901504 | 05 |
| Other Name | Type Code |
|---|---|
| ResourceCare Breckenridge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194804278 | Shackelford County Community Resource Center | Clinic/Center | 725 Pate Street, Albany, TX 76430 | 2006-11-02 |
| 1184096273 | Shackelford County Community Resource Center | Clinic/Center | 217 Edwards, Merkel, TX 79536-3803 | 2015-10-28 |
| 1437551710 | Shackelford County Community Resource Center | Clinic/Center | 200 N Main St, Cross Plains, TX 76443-3312 | 2014-09-18 |
| 1215205265 | Shackelford County Community Resource Center | Clinic/Center | 1712 North Access Road, Clyde, TX 79510 | 2011-12-06 |
| 1881985299 | Shackelford County Community Resource Center | Clinic/Center | 301 S Main St, Cross Plains, TX 76443-2581 | 2011-04-20 |
| 1073749784 | Shackelford County Community Resource Center | Clinic/Center | 128 W 4th St, Baird, TX 79504-5314 | 2009-06-09 |
| Street Address |
2802 W WALKER ST |
| City | BRECKENRIDGE |
| State | TX |
| Zip Code | 76424-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982687067 | John Ellis Horner | Dentist | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2005-11-22 |
| 1457981458 | Tamryn Elizabeth Anderson | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2020-01-19 |
| 1790329134 | Chelsea Michelle Dickson | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2019-10-29 |
| 1154899037 | Marcela Martinez | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2018-11-08 |
| 1487151452 | Sandra Usaiwevu | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2018-04-06 |
| 1629447859 | Cortney Rachelle Berkley | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2015-09-17 |
| 1417293598 | Diana Lee Price | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2012-12-18 |
| 1346560273 | Sara Susan Wilcox | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2010-06-02 |
| 1669637831 | Carol Lynn Copelin | Nurse Practitioner | 2802 W Walker St, Breckenridge, TX 76424 | 2008-07-27 |
| 1275790727 | Kerry G. Snow | Dentist | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2008-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972944833 | Clear Path Home Care LLC | In Home Supportive Care | 1515 West Walker St, Breckenridge, TX 76424 | 2013-07-08 |
| 1134565732 | Breckenridge Isd | Local Education Agency (LEA) | 206 North Miller St, Breckenridge, TX 76424 | 2013-05-22 |
| 1003063124 | Jeanene R Poston | Social Worker | 117 W Walker St., Breckenridge, TX 76424 | 2008-08-20 |
| 1841462033 | Bez Diagnostics | Clinic/Center | 151 Fm 207, Breckenridge, TX 76424 | 2008-03-27 |
| 1134249873 | Josephine Sally Kelly | Counselor | 101 E Walker St, Suite 512 & 513, Breckenridge, TX 76424 | 2007-03-29 |
| 1780782672 | Breckenridge Family Clinic Pa | Family Medicine | 103 South Hartford Street, Breckenridge, TX 76424 | 2006-09-21 |
| 1083623326 | Todd Martin Pennartz | Dentist | 1905 W Walker St, Breckenridge, TX 76424 | 2006-08-05 |
| 1720031321 | Stephanie Elnora Stafford | Emergency Medicine | 101 South Hartford, Breckenridge Medical Clinic, Breckenridge, TX 76424 | 2006-05-18 |
| 1205257029 | Stephens Memorial Hospital District | Medicare Defined Swing Bed Unit | 200 S Geneva St, Breckenridge, TX 76424 | 2013-12-20 |
| 1912114406 | Jenifer Lynn Campbell | Physical Therapist | 201 Ridge Rd, Breckenridge, TX 76424-1901 | 2007-05-16 |
| Find all providers in zip 76424 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1912508235 | Legacy Community Health Services, Inc | Clinic/Center | 120 Westheimer Rd., Suite F, Houston, TX 77006-3332 | 2020-11-03 |
| 1720688534 | Barrio Comprehensive Family Health Care Center, Inc. | Clinic/Center | 11930 Us Highway 90, Suite 110, San Antonio, TX 78252 | 2020-10-30 |
| 1053918516 | Legacy Community Health Services, Inc. | Clinic/Center | 13703 Aldine Westfield Rd, Houston, TX 77039-2001 | 2020-10-07 |
| 1205449386 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Drive Suite 1305, Wharton, TX 77488 | 2020-08-28 |
| 1568075638 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center, Suite 1317, Wharton, TX 77488-9719 | 2020-08-28 |
| 1144831835 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center Drive Suite 1315, Wharton, TX 77488-9719 | 2020-08-14 |
| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| Find all providers with the same taxonomy | ||||
| City | BRECKENRIDGE |
| Zip Code | 76424 |
Please comment or provide details below to improve the information on SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER.
| 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.