Fred Health Care, PLLC | NPI 1023044062

Key facts

NPI: 1023044062
Entity type: Organization (NPI type 2)
Primary specialty: Public Health or Welfare Agency 251K00000X
Legal business name: FRED HEALTH CARE, PLLC
Practice address: Highway 92 North
Fred, TX 77616
Phone: (409) 651-5566
NPI assigned: Jun 23, 2006
Organization subpart: No

Authorized official

Name: Mr. Kim Best, PA
Title: Manager
Phone: (409) 651-5566

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Kim Donald Best, P.A. CW-2 RET Physician Assistant · Fred, TX · NPI 1154302644

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Fred Health Care P L L C Rural Health Clinic/Center · Fred, TX · NPI 1447445887

Same enrollment O20061101000197

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Kim Donald Best, P.A. CW-2 RET Physician Assistant · Fred, TX · NPI 1154302644

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TX

Rural health clinic certification: CCN 673899

Legal name: FRED HEALTH CARE P L L C
Certification status: Active
Provider type (POS): Rural health clinic
Participating since: Feb 21, 2007
Last certification: Jan 14, 2020
Ownership / control type: 1B
Organization structure: LLC · Proprietary
Incorporated: Jan 24, 2006 in TX
Enrollment address: 20290 FM 92 South
Fred, TX 77616-9527

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Name	Role	Since	Share
Kim D Best Individual	5% Or Greater Direct Ownership Interest	Apr 15, 2006	49%
Deborah Best Individual	5% Or Greater Direct Ownership Interest	Apr 15, 2006	51%
Deborah Best Individual	W-2 Managing Employee	Apr 15, 2006

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20061101000197	TX	Part a Provider - Rural Health Clinic	4183628555	1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fred, TX

National Provider Directory

Locations

20290 FM 92 S
#337
Fred, TX 77616
Phone (409) 429-4949

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Public Health or Welfare Agency	251K00000X		TX	Yes

Addresses

Primary practice location

Highway 92 North
Fred, TX 77616

Mailing address

Highway 92 North
P O Box 337
Fred, TX 77616
Phone (409) 651-5566

Other providers in Fred, TX

Kim Donald Best, P.A. CW-2 RET
Fred Health Care P L L C

All providers in Fred, TX · Public Health or Welfare Agency in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.