Individual provider Active NPI

Jorge Cardenas, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Altus, OK
National Provider Identifier
1013542406
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
135841 Issued in OK
Practice address
205 S Park LN
Altus, OK 73521-5755
Phone
(580) 379-6650
NPI assigned
Mar 6, 2020
Last updated
May 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 135841 OK Primary
Medical-Surgical Registered Nurse 163WM0705X 824786 TX

Addresses

Primary practice location

205 S Park LN
Altus, OK 73521-5755

Mailing address

PO Box 229
Vernon, TX 76385-0229
Phone (940) 886-7222

Other practice location 1

1600 11th St
Wichita Falls, TX 76301-4300
Phone (940) 764-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jorgecardenaspmhnp@hotmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200609003208 OK Practitioner - Nurse Practitioner 3678994167 Reassigns benefits to 1 organization
I20210907000040 TX Practitioner - Nurse Practitioner 3678994167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Helen Farabee CentersGroup PAC ID 8729042916, 13 clinicians

Practice addresses (Care Compare)

1000 Brook Ave
Wichita Falls, TX 76301-5007
Phone (940) 397-3143

1000 Brook St
Wichita Falls, TX 76301-5007

1200 E Pecan St
Altus, OK 73521-6141

205 S Park LN
Suite 210
Altus, OK 73521-5757
Phone (580) 379-6650

500 Broad St
Wichita Falls, TX 76301-3109
Phone (940) 397-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
824786TXMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority CurrentSince Jun 8, 2020 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jun 8, 2020 Accepting new patients
Helen Farabee Centers CurrentSince Jul 1, 2021 Accepting new patients
Helen Farabee Regional Centers Past Accepting new patients

Locations

205 S Park Ln
Altus, OK 73521
Phone (580) 379-6650

205 S Park Ln
Ste 210
Altus, OK 73521
Phone (580) 379-6650

8150 US Highway 287
Childress, TX 79201
Phone (940) 536-3644

1720 4th St
Graham, TX 76450
Phone (940) 549-4896

510 King St
Quanah, TX 79252
Phone (940) 536-3644

301 N Washington St
Seymour, TX 76380
Phone (940) 889-2277

2500 Wilbarger St
Vernon, TX 76384
Phone (940) 553-4002

1000 Brook Ave
Wichita Falls, TX 76301
Phone (940) 397-3100

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

500 Broad St
Wichita Falls, TX 76301
Phone (940) 397-3300

516 Denver St
Wichita Falls, TX 76301
Phone (940) 720-3500

Interoperability endpoints

  • Direct secure messaging: jorgecardenas@direct.jcmh.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1013542406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 229",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763850229",
            "telephone_number": "940-886-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S PARK LN",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215755",
            "telephone_number": "580-379-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 11th St",
            "address_purpose": "LOCATION",
            "city": "Wichita Falls",
            "state": "TX",
            "postal_code": "763014300",
            "country_code": "US",
            "telephone_number": "940-764-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "JORGE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "135841",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "824786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jorgecardenaspmhnp@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 S Park Ln",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.