Active NPI
Cody Hamra
- Psychiatric/Mental Health Nurse Practitioner
- San Angelo, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1226337
- Practice address
- 3555 Knickerbocker Rd
San Angelo, TX 76904-7610 - Phone
- (325) 747-8033
- NPI assigned
- Apr 10, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1226337 | TX | Primary |
Addresses
Primary practice location
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Mailing address
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-8033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511
Hospital & facility affiliations
- Shannon Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1226337 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Clinic | Current | Accepting new patients |
Locations
3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411
120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511
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.
-
- Family Medicine Physician
- San Angelo, TX
- NPI 1770587149
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Angelo, TX
- NPI 1992707228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770163200000",
"number": "1699560748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 KNICKERBOCKER RD",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769047610",
"telephone_number": "325-747-8033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 KNICKERBOCKER RD",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769047610",
"telephone_number": "325-747-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMRA",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-10",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1226337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.