Tiffany Kay Headrick, NP-C
Individual provider Active NPI Family Nurse Practitioner · Bandera, TX
NPI 1124780556 · NPPES record last updated Oct 4, 2022
Key facts
- NPI
- 1124780556
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1056849 (TX)
- Practice address
- 1050 Hwy 16 S
Bandera, TX 78003-4830 - Phone
- (830) 426-6299
- NPI assigned
- Oct 13, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medcare Associates PA
Practice addresses (Care Compare)
1050 State Hwy 16 S
Bandera, TX 78003-4830
Phone (830) 796-7713
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211027000228 | TX | Practitioner - Nurse Practitioner | 3072901917 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1056849 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medcare Associates, P.a. | Current |
Accepting new patients | |
| Methodist Healthcare System of San Antonio, LTD., L.L.P. | Past |
Accepting new patients | |
| Medcare Associates PA | Past | Accepting new patients |
Locations
1050 State Highway 16 S
Bandera, TX 78003
Phone (210) 874-3270
1051 US Highway 90 E
Castroville, TX 78009
Phone (830) 931-3336
19260 Stone Oak Pkwy
Ste 105
San Antonio, TX 78258
Phone (210) 402-3456
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1056849 | TX | Yes |
Addresses
Primary practice location
1050 Hwy 16 S
Bandera, TX 78003-4830
Mailing address
1050 State Highway 16 S
Bandera, TX 78003-4830
Phone (830) 796-7713
Other providers in Bandera, TX
- Susan K Grigsby
- Molyne Martinez Hacker
- Hamilton County Hospital District
- Jeremy Hannegan
- Kelly Ann Harris
- Jeanie K Heidelberg
- Leticia Henk
- Jeanne Marie Hernandez
- Pearl Marie Herrera
- Lacy Herrmann
All providers in Bandera, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2022. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.