Abilene Bone & Joint Clinic
Organization Active NPI Orthopaedic Surgery Physician · Abilene, TX
NPI 1699701870 · NPPES record last updated Jun 1, 2010
Key facts
- NPI
- 1699701870
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ABILENE BONE & JOINT CLINIC
- Practice address
- 1749 Pine St
Abilene, TX 79601-3043 - Phone
- (325) 672-4372
- Fax
- (325) 673-0856
- NPI assigned
- Jun 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Shannon Eugene Cooke, M.D.
- Title
- President
- Phone
- (325) 672-4372
Practitioners 18
-
Jeremy Blaine Britten, M.D.
-
Shannon Eugene Cooke, M.D.
-
James B Nicholls, PT
-
Derek Timothy Padon, M.D.
-
Shona Preston, F.N.P.
-
Brian William Sager, M.D.
-
David Michael Stark, M.D.
-
Paul Wallace Watts, D.O.
-
Ginger D Wood, MPT
-
Kerry D Frazier, PA
-
Kenda M Luker, PA-C
-
Jividen James McCoy, PA-C
-
Stephen Salaz Jr., PA-C
-
Marcus Spencer, PA-C
-
Chad A Walters, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040723001006 | TX | Part B Supplier - Clinic/Group Practice | 6800876368 |
Receives reassigned benefits from 18 practitioners Practice locations: Abilene, TX |
National Provider Directory
Locations
1633 Cottonwood St
Abilene, TX 79601
Phone (325) 672-4372
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 6357380001 | TX | |
| Prosthetic/Orthotic Supplier | 335E00000X | 6357380001 | TX |
Addresses
Primary practice location
1749 Pine St
Abilene, TX 79601-3043
Mailing address
1749 Pine St
Abilene, TX 79601-3043
Phone (325) 672-4372
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0075MS | Other | TX | BCBS GROUP # |
| 170619401 | Medicaid | TX |
Other providers in Abilene, TX
- Abilene Ambulatory Surgery Center for Pain Management, LLC
- Abilene Artificial Limb Co. LLP
- Abilene ASC LP
- Abilene Audiology Co., LLC
- Abilene Behavioral Health, LLC
- Abilene Cardiology Consultants PA
- Abilene Cardiovascular Surgery, P.a.
- Abilene Center for Orthopedic and Multispecialty Surgery, L.L.C.
- Abilene Children'S Medical Association, LLP
- Abilene Chiropractic Associates
All providers in Abilene, TX · Orthopaedic Surgery 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 Jun 1, 2010. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.