NPIMap

Organization Active NPI

Anderson Cherokee Community Enrichment Services

  • Case Manager/Care Coordinator
  • Jacksonville, TX
National Provider Identifier
1265560767
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Practice address
1011 College Ave
Jacksonville, TX 75766
Phone
(903) 589-9000
Fax
(903) 586-9200
NPI assigned
Feb 28, 2007
Last updated
Jul 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Authorized official

Name
Dianna Strom
Title
Reimbursement Coordinator
Phone
(903) 589-9000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 14498 TX
Counselor 101Y00000X 17029 TX
Counselor 101Y00000X 12741 TX
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

1011 College Ave
Jacksonville, TX 75766

Mailing address

5656 N Jackson St
Jacksonville, TX 75766-9641
Phone (903) 589-9000

Other identifiers 1

IdentifierTypeStateIssuer
096107001MedicaidTX

Other names 1

  • ACCESS Other name

National Provider Directory

National Provider Directory
Tax ID family
Access15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

5656 N Jackson St
Jacksonville, TX 75766
Phone (903) 589-9000

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1265560767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 N JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757669641",
            "telephone_number": "903-589-9000",
            "fax_number": "903-586-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "75766",
            "telephone_number": "903-589-9000",
            "fax_number": "903-586-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "STROM",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "REIMBURSEMENT COORDINATOR",
        "authorized_official_telephone_number": "903-589-9000"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "14498",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "17029",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "12741",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096107001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACCESS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ACCESS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.