Rachel Kaye Shafer, MSN, APRN, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP144249 Issued in TX

Practice address

102 Medical Dr
Victoria, TX 77904-3101

Phone

(361) 580-5195

Fax

(361) 572-9320

NPI assigned

Dec 12, 2019

Last updated

Dec 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rachel Kaye Jackson Former name

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pam Physician EnterpriseGroup PAC ID 1254628589, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pam Health at Home Home health agency, Buda, TX, CCN 747688
• Citizens Medical Center Hospital, Victoria, TX, CCN 450023
• De Tar Hospital Navarro Hospital, Victoria, TX, CCN 450147
• Pam Specialty Hospital of Victoria North Long-term care hospital, Victoria, TX, CCN 452094

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pam Physician Enterprise

  • Physical Medicine & Rehabilitation Physician
  • Fargo, ND
  • NPI 1962856161

  TX

  Medicare reassignment Care Compare group NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)
• Pam Squared at Dover LLC

  dba PAM Rehabilitation Hospital of Dover

  • Rehabilitation Hospital
  • Dover, DE
  • NPI 1295221372
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Be Healthy at Home

  • Home Health Agency
  • Buda, TX
  • NPI 1548439565
  Care Compare affiliation
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  Care Compare affiliation
• Post Acute Medical at Victoria LLC

  dba PAM Specialty Hospital of Victoria North

  • Long Term Care Hospital
  • Victoria, TX
  • NPI 1659316115

  Long-term care hospital

  Care Compare affiliation
• Victoria of Texas LP

  dba Detar Healthcare System

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1851343909
  Care Compare affiliation

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1114565884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEDICAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043101",
            "telephone_number": "361-580-5195",
            "fax_number": "361-572-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MEDICAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043101",
            "telephone_number": "361-580-5195",
            "fax_number": "361-572-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "RACHEL",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP144249",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP144249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "JACKSON",
            "middle_name": "KAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Senior Health Physicians PA
• Senior Medical PA
• Sara Marie Serrano, LPC
• Timothy Serrano
• Amanda Adams Sewalt, DDS
• Shah N. Afridi, M.D., P.a.
• Niyati Shah, PHARMD
• Rabia Shahid, MD
• Laurie A Shamma, PT
• Shipra Sharma

• Adult Health Nurse Practitioner in Victoria, TX
• Providers in Victoria, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.