NPIMap

Organization Active NPI

Abilene Regional MHMR Center

  • Developmental Disabilities Clinic/Center
  • Abilene, TX
National Provider Identifier
1699741975
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ABILENE REGIONAL MHMR CENTER
Practice address
2616 S Clack
Ste 160
Abilene, TX 79606-1557
Phone
(325) 690-5131
Fax
(325) 690-5263
NPI assigned
Feb 27, 2006
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Mrs. Jennifer K Goode, CEO
Title
Ceo Chief Executive Officer
Phone
(325) 690-5135

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Registered Dietitian 133V00000X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Case Management Agency 251B00000X NU
Clinic/Center 261Q00000X NU
Developmental Disabilities Clinic/Center 261QD1600X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Early Intervention Provider Agency 252Y00000X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

2616 S Clack
Ste 160
Abilene, TX 79606-1557

Mailing address

2616 S Clack
Ste 160
Abilene, TX 79606-1557
Phone (325) 690-5131

Other identifiers 4

IdentifierTypeStateIssuer
133338706MedicaidTX
133338702MedicaidTX
00R652OtherTXMULTI-SPECIALITY
133338707MedicaidTX

Other names 1

  • Betty Hardwick Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050110001165 TX Part B Supplier - Clinic/Group Practice 9537117197 Receives reassigned benefits from 18 practitioners
Practice locations: Abilene, TX; Breckenridge, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1699741975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 S CLACK",
            "address_2": "STE 160",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5131",
            "fax_number": "325-690-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 S CLACK",
            "address_2": "STE 160",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5131",
            "fax_number": "325-690-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILENE REGIONAL MHMR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "325-690-5135",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133338706",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133338702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-SPECIALITY",
            "identifier": "00R652",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133338707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Betty Hardwick Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Betty Hardwick Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.