Caritas Family Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L8002 Issued in TX

Legal business name

CARITAS FAMILY MEDICINE PA

Practice address

11901 Toepperwein Rd
Suite 1201
Live Oak, TX 78233-3161

Phone

(210) 650-9066

Fax

(210) 650-9067

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey Alexander Cannon, MDNPI 1174638902

Title

President

Phone

(210) 650-9066

Specialties & licenses 1

Addresses

Other identifiers 5

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 3

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.

• Jeffrey Alexander Cannon, M.D

  • Family Medicine Physician
  • Live Oak, TX
  • NPI 1174638902
  Medicare reassignment Care Compare group NPD Authorized official
• Michael James Rosedale, D.O.

  • Family Medicine Physician
  • Live Oak, TX
  • NPI 1205096906
  Medicare reassignment Care Compare group NPD
• Stella Leonora Winters, M.D.

  • Family Medicine Physician
  • Rio Grande City, TX
  • NPI 1942647839
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1215042189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 TOEPPERWEIN RD",
            "address_2": "SUITE 1201",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333161",
            "telephone_number": "210-650-9066",
            "fax_number": "210-650-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 TOEPPERWEIN RD",
            "address_2": "SUITE 1201",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333161",
            "telephone_number": "210-650-9066",
            "fax_number": "210-650-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-650-9066",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112162601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00178727",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010025319",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8P1540",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8P1541",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cancer Care Network of South Texas PA
• Jeffrey Alexander Cannon, M.D
• Axel Cardenas
• Hal Victor Cardiff Jr.
• Sarah Jessica Cardwell, MSN, APRN, FNP-C
• Samuel Carmona, PTA
• Valaree Carney, MSN, APRN, FNP-C
• Christopher Caroll
• Madison Carr, BCBA
• Matthew Carranza

• Family Medicine Physician in Live Oak, TX
• Providers in Live Oak, 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 Apr 5, 2017; 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.