NPIMap

Organization Active NPI

Cedar Crest Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wichita Falls, TX
National Provider Identifier
1083384424
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CEDAR CREST CLINIC
Doing business as
Cedar Crest Clinic
Practice address
1505 8TH St
Wichita Falls, TX 76301-3106
Phone
(940) 322-3171
Fax
(940) 761-5335
NPI assigned
Sep 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Brian P Farley
Title
Vice President & Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1505 8TH St
Wichita Falls, TX 76301-3106

Mailing address

6100 Tower Cir Ste 1000
Franklin, TN 37067-1509
Phone (615) 861-6000

Other names 1

  • Cedar Crest Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000632 TX Part B Supplier - Clinic/Group Practice 9537063409 Receives reassigned benefits from 18 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Austin, TX; Belton, TX; Killeen, TX; Wichita Falls, TX

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

404 W 9th St
Ste 104
Georgetown, TX 78626
Phone (512) 635-6130

3106 S W S Young Dr
Ste 201B
Killeen, TX 76542
Phone (254) 519-4162

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1083384424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 TOWER CIR STE 1000",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671509",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 8TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763013106",
            "telephone_number": "940-322-3171",
            "fax_number": "940-761-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREST CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Crest Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedar Crest Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.