Jacquelene Mitchell Adiele, M.D.
Individual provider Active NPI Internal Medicine Physician · Killeen, TX
NPI 1609896497 · NPPES record last updated Dec 17, 2013
Key facts
- NPI
- 1609896497
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- J2678 (TX)
- Practice address
- 3816 S Clear Creek Rd
Suite a
Killeen, TX 76549-4400 - Phone
- (254) 200-2748
- Fax
- (254) 200-2757
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Privia Medical Group Gulf Coast PLLC
Practice addresses (Care Compare)
17510 W Grand Pkwy S
Sugar Land, TX 77479-2649
3816 Clear Creek Rd
Suite a
Killeen, TX 76549-4107
3816 Clear Creek Rd
Suite E
Killeen, TX 76549-4401
Phone (254) 544-8773
7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500
Hospital & facility affiliations
- Elara Caring
- Adventhealth Central Texas
- Seton Medical Center Harker Heights
- Baylor Scott & White Medical Center - Temple
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060906000289 | TX | Practitioner - Internal Medicine | 0446254452 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacquelene Mitchell Adiele, MD, PA | Internal Medicine | Current |
Accepting new patients |
| Stillhouse Emergency Physicians | Past | Accepting new patients | |
| William S Marsh III, DO, PA | Past | Accepting new patients | |
| Ctems Inc | Past | Accepting new patients |
Locations
3816 Clear Creek Rd
Ste A
Killeen, TX 76549
Phone (254) 200-2748
Interoperability endpoints
- jacqueline.adiele.1@29236.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | J2678 | TX | Yes |
Addresses
Primary practice location
3816 S Clear Creek Rd
Suite a
Killeen, TX 76549-4400
Mailing address
PO Box 938
Killeen, TX 76540-0938
Phone (254) 634-6999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 034049902 | Medicaid | TX | |
| 1609896497 | Other | INDIVIDUAL NPI | |
| TXB158053 | Other | TX | MEDICARE |
| J2678 | Other | TX | TX MEDICAL BOARD LICENSE |
Other providers in Killeen, TX
- Chloe Dionne Adams
- Courtney Adams
- Yadhira Charlett Adams
- Mary-Catherine Kellam Addison-McQuitty
- Kwame Addo
- Ahadu Lakew Admassie
- Adolescent & Family Counseling Center, Inc.
- Adonaijah Support Services LLC
- Neko N Adorka
- Adult Child and Family Counseling Center
All providers in Killeen, TX · Internal Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.