Organization Active NPI

Affinity Family Health, PLLC

  • Family Nurse Practitioner
  • Cisco, TX
National Provider Identifier
1629468087
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127254 Issued in TX
Legal business name
AFFINITY FAMILY HEALTH, PLLC
Practice address
707 Conrad Hilton Blvd
Cisco, TX 76437-3139
Phone
(913) 709-9098
NPI assigned
Jan 23, 2015
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Jacqueline Belk, NP-CNPI 1821487604
Title
Managing Member
Phone
(254) 488-4865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP127254 TX Primary

Addresses

Primary practice location

707 Conrad Hilton Blvd
Cisco, TX 76437-3139

Mailing address

707 Conrad Hilton Blvd
Cisco, TX 76437-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150615000727 TX Part B Supplier - Clinic/Group Practice 0547571739 Receives reassigned benefits from 3 practitioners
Practice locations: Cisco, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2098151Affinity Family Health, PLLC707 Conrad Hilton Blvd, Cisco, TX 76437Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Locations

707 Conrad Hilton Blvd
Cisco, TX 76437
Phone (254) 488-4865

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1629468087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CONRAD HILTON BLVD",
            "city": "CISCO",
            "state": "TX",
            "postal_code": "764373139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CONRAD HILTON BLVD",
            "city": "CISCO",
            "state": "TX",
            "postal_code": "764373139",
            "telephone_number": "913-709-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY FAMILY HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "BELK",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "254-488-4865",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.