Individual provider Active NPI

Rebecca L Shumake

  • Clinical Social Worker
  • Waco, TX
National Provider Identifier
1043109408
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
53465 Issued in TX
Practice address
6700 Sanger Ave
Waco, TX 76710-4208
Phone
(254) 399-9099
NPI assigned
Jul 1, 2025
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 53465 TX Primary

Addresses

Primary practice location

6700 Sanger Ave
Waco, TX 76710-4208

Mailing address

3001 Saddlebrook
Waco, TX 76712-8384
Phone (254) 855-9942

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013004076 TX Practitioner - Clinical Social Worker 0446747539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chot Healthcare ProvidersGroup PAC ID 2163881228, 8 clinicians

Practice addresses (Care Compare)

6100 Western PL
Suite 105
Fort Worth, TX 76107-4662
Phone (817) 870-2795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53465TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Chot Healthcare Providers CurrentSince Jul 15, 2025 Accepting new patients
Community Healthcare of Texas PastSince Jul 9, 2025 Accepting new patients
Community Healthcare of Texas PastSince Jul 9, 2025 Accepting new patients

Locations

6100 Western Pl
Ste 105
Ft Worth, TX 76107
Phone (817) 870-2795

Organizations & group practices 3

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1043109408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SADDLEBROOK",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128384",
            "telephone_number": "254-855-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 SANGER AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104208",
            "telephone_number": "254-399-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKE",
        "first_name": "REBECCA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.