NPIMap

Organization Active NPI

Shackelford County Community Resource Center

Doing business as ResourceCare Albany

  • Federally Qualified Health Center (FQHC)
  • Albany, TX
National Provider Identifier
1194804278
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
30117281979 Issued in TX
Legal business name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Doing business as
ResourceCare Albany
Practice address
725 Pate St
Albany, TX 76430-3225
Phone
(325) 762-2447
Fax
(325) 762-2186
NPI assigned
Nov 2, 2006
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Tina Louise Betcher
Title
Billing Manager/Credentialer
Phone
(325) 893-4010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 30117281979 TX Primary

Addresses

Primary practice location

725 Pate St
Albany, TX 76430-3225

Mailing address

PO Box 2435
Albany, TX 76430-8020
Phone (325) 762-2447

Other identifiers 5

IdentifierTypeStateIssuer
214962701MedicaidTX
287755701MedicaidTX
171901505MedicaidTX
171901503MedicaidTX
171901504MedicaidTX

Other names 1

  • ResourceCare Albany Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20050121000572 TX Part B Supplier - Clinic/Group Practice 8628027174 Receives reassigned benefits from 26 practitioners
1 other NPI on this enrollment
Practice locations: Baird, TX; Albany, TX; Merkel, TX; Cross Plains, TX; Breckenridge, TX; Clyde, TX
O20080609000104 TX Part A Provider - Federally Qualified Health Center (FQHC) 8628027174 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cross Plains, TX
O20101110000123 TX Part A Provider - Federally Qualified Health Center (FQHC) 8628027174 Practice locations: Albany, TX
O20101110000421 TX Part A Provider - Federally Qualified Health Center (FQHC) 8628027174 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Breckenridge, TX

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1194804278. Details of each certification follow.

Federally qualified health center certification: CCN 671893

Legal name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Doing business as
RESOURCECARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 7, 2008
Last certification
Jul 7, 2008
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jun 16, 1994 in TX
Enrollment address
301 S Main St
Cross Plains, TX 76443-2581

Federally qualified health center certification: CCN 671830

Legal name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Doing business as
RESOURCECARE ALBANY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 22, 2006
Last certification
Feb 22, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 16, 1994 in TX
Enrollment address
725 Pate St
Albany, TX 76430-3225

Federally qualified health center certification: CCN 671831

Legal name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Doing business as
RESOURCECARE BRECKENRIDGE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 22, 2006
Last certification
Feb 22, 2006
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jun 16, 1994 in TX
Enrollment address
2802 W Walker St
Breckenridge, TX 76424-4000

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Ownership & related parties

All disclosed owners & managing parties 27

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Eileen Piwetz Individual Corporate Director Oct 27, 2022
Corporate DirectorBoard Member Oct 27, 2022
Sylvia Robinson Individual Corporate Director Aug 1, 2023
Corporate DirectorBoard Member Aug 1, 2023
Rea Barry Individual Corporate Director Nov 1, 2023
Corporate DirectorBoard Member Nov 1, 2023
Jeanie F Stephens Individual Corporate DirectorBoard Secretary Mar 14, 2006
Corporate DirectorBoard Secretary Oct 22, 2015
Ryan Wade Individual Corporate Director May 27, 2025
Corporate DirectorDirector of Financial Planning May 27, 2025
W-2 Managing EmployeeDirector of Financial Planning May 27, 2025
Joel S Deel Individual Corporate DirectorBoard Member Oct 22, 2015
Corporate DirectorBoard Member Oct 1, 2015
William W Thompson Individual Corporate Director Oct 28, 2021
Corporate DirectorBoard Member Oct 28, 2021
Scott Clifford Byrd Individual Corporate DirectorBoard President Jun 27, 2012
Corporate DirectorVice President of Board Jun 27, 2012
Kathleen Tippy Individual Corporate Director Oct 22, 2020
Corporate DirectorBoard Member Oct 22, 2020
Jeff D Graham Individual Corporate DirectorBoard Treasurer Jun 25, 2015
Amy Kelly Individual Corporate DirectorBoard Member Oct 26, 2017
Corporate DirectorBoard Member Oct 25, 2017
David Estes Individual Corporate Director Oct 27, 2022
Corporate DirectorBoard Member Oct 27, 2022
Carrol Kanady Individual Corporate Director Dec 17, 2020
Corporate DirectorBoard Member Dec 17, 2020
Tina L Betcher Individual W-2 Managing EmployeeBilling Manager Dec 1, 2008
Joel Johnson Individual Corporate Director Oct 27, 2022
Corporate DirectorBoard Member Oct 27, 2022
Patrick Butler Individual Corporate DirectorCeo Nov 17, 2025
W-2 Managing EmployeeCeo Nov 17, 2025
Phillip Rodriguez Individual Corporate Director Nov 1, 2023
Melinda Noemi Presley Individual Corporate DirectorBoard Member Oct 1, 2015
Corporate DirectorBoard Member Oct 22, 2015
Karen K Lenz Individual Corporate DirectorBoard Member Oct 22, 2015
Paula Leann Kinslow Individual Corporate DirectorBoard Member Oct 23, 2014
Patricia R Knight Individual Corporate DirectorBoard Vice President Jun 27, 2012
Eric Varela Individual W-2 Managing EmployeeChief Financial Officer Oct 27, 2013
Jan F Windham Individual Corporate DirectorBoard Member Oct 1, 2013
Bryan Allen Individual Corporate DirectorBoard Member Oct 1, 2018
Brenda Hernandez Individual Corporate DirectorBoard Member Oct 25, 2017
Cynthia a Perry Individual W-2 Managing EmployeeChief Medical Officer Sep 12, 2011
Sharon K Trigg Individual Corporate DirectorBoard Member Oct 23, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Resourcecare BairdBaird, TX, CCN 671909 Federally qualified health center Operational/Managerial Control Jun 1, 2011
Resourcecare ClydeClyde, TX, CCN 671976 Federally qualified health center Operational/Managerial Control Feb 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1194804278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2435",
            "city": "ALBANY",
            "state": "TX",
            "postal_code": "764308020",
            "telephone_number": "325-762-2447",
            "fax_number": "325-762-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 PATE ST",
            "city": "ALBANY",
            "state": "TX",
            "postal_code": "764303225",
            "telephone_number": "325-762-2447",
            "fax_number": "325-762-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "BETCHER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING MANAGER/CREDENTIALER",
        "authorized_official_telephone_number": "325-893-4010"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "30117281979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214962701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287755701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171901505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171901503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171901504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ResourceCare Albany",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ResourceCare Albany",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, TX

Sources for this page

Verify at the official NPI Registry.