Active NPI
Jimmy Ward
- Professional Counselor
- Brownwood, TX
National Provider Identifier
1275935272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69682
- Practice address
- 205 Center Ave
Brownwood, TX 76801-2919 - Phone
- (325) 649-4357
- Fax
- (325) 646-0919
- NPI assigned
- Sep 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12659 | TX | |
| Professional Counselor | 101YP2500X | 69682 | TX | Primary |
Addresses
Primary practice location
205 Center Ave
Brownwood, TX 76801-2919
Mailing address
PO Box 1391
Brownwood, TX 76804-1391
Phone (325) 649-4357
Other practice location 1
1506 N Greenville Ave
Suite 200
Allen, TX 75002-8622
Phone (469) 854-9640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12659 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 69682 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennissi P. Taylor PH.D,PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Brownwood, TX
- NPI 1114073830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1275935272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1391",
"city": "BROWNWOOD",
"state": "TX",
"postal_code": "768041391",
"telephone_number": "325-649-4357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 CENTER AVE",
"city": "BROWNWOOD",
"state": "TX",
"postal_code": "768012919",
"telephone_number": "325-649-4357",
"fax_number": "325-646-0919"
}
],
"practiceLocations": [
{
"address_1": "1506 N Greenville Ave",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Allen",
"state": "TX",
"postal_code": "750028622",
"country_code": "US",
"telephone_number": "469-854-9640",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WARD",
"first_name": "JIMMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-22",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "12659",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownwood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.