Rebecca Ann Liles

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8653-C Issued in AR

Practice address

1400 College Dr
Texarkana, TX 75503-3536

Phone

(903) 791-1110

Fax

(903) 791-9352

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Border Health ClinicGroup PAC ID 8820038565, shared by 11 NPIs, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, AR
  • NPI 1093186249
  Medicare reassignment NPD
• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, AR
  • NPI 1548745383

  Social Worker

  NPD
• East Texas Border Health Clinic

  dba Genesis PrimeCare Pharmacy Marshall

  • Community/Retail Pharmacy
  • Marshall, TX
  • NPI 1073485082
  NPD (past)
• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1700134996
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1578066452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COLLEGE DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033536",
            "telephone_number": "903-791-1110",
            "fax_number": "903-791-9352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4077 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718541509",
            "country_code": "US",
            "telephone_number": "870-330-9200",
            "fax_number": "870-330-9439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILES",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "8653-C",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "64819",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8653-C",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessie Liang, MD
• Liberty Eylau Independent School District
• Lifecare Medical Supply, Inc.
• Lifenet, Inc. (Lifenet)
• Lifenet, Inc.
• Lincare Inc (United Medical)
• Lincare Inc. (Home Oxygen 2U)
• Lippian Family Dentistry, P.C.
• Adriane Louise Lippian, DDS
• James Michael Lippian, DDS

• Social Worker in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.