Pain Care Clinics, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PAIN CARE CLINICS, PA

Doing business as

CARE CLINICS, PA

Practice address

703 Hill Country Dr Ste 301
Kerrville, TX 78028-6162

Phone

(830) 792-4805

Fax

(830) 792-4883

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jon Eric Chancellor, MDNPI 1598708794

Title

Owner

Phone

(830) 792-4805

Specialties & licenses 6

Addresses

Other identifiers 4

Other names 1

• CARE CLINICS, PA Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Jon Eric Chancellor, MD

  • Family Medicine Physician
  • Kerrville, TX
  • NPI 1598708794
  Medicare reassignment NPD Authorized official
• Michelle Jones, NP

  • Family Nurse Practitioner
  • Coppell, TX
  • NPI 1730432493
  Medicare reassignment NPD
• Nubia Paola Forero Medina, MD

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1346553146
  NPD (past)
• Madhavi A Reddy, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1588667471
  NPD (past)
• Georgia W Roth, M.D.

  • Family Medicine Physician
  • Kerrville, TX
  • NPI 1831284876
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1144271578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 HILL COUNTRY DR STE 301",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286162",
            "telephone_number": "830-792-4805",
            "fax_number": "830-792-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 HILL COUNTRY DR STE 301",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286162",
            "telephone_number": "830-792-4805",
            "fax_number": "830-792-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE CLINICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "CHANCELLOR",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-792-4805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0047KP",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163190502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID, TSTEPS",
            "identifier": "163190503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC1911",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARE CLINICS, PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CARE CLINICS, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah J Otka, RN
• Connie Owens
• Karen Owens, SLP
• P-9 Enterprises, Inc.
• Paige Priour DDS PLLC
• Jennifer Emalynne Palmer, APRN-CNP
• Lendon Danny Palmer Jr., LVN
• Vishal Panchmatia, D.M.D.
• Hayley Pannone, COTA
• James T Papesca, CRNA

• Family Medicine Physician in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.