NPIMap

Individual provider Active NPI

Joanne Carpenter Paulk, DO

  • Family Medicine Physician
  • Cross Plains, TX
National Provider Identifier
1700848850
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K4521 Issued in TX
Practice address
301 S Main St
Cross Plains, TX 76443-2581
Phone
(254) 725-4311
Fax
(254) 725-4313
NPI assigned
Apr 4, 2006
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K4521 TX Primary

Addresses

Primary practice location

301 S Main St
Cross Plains, TX 76443-2581

Mailing address

PO Box 2435
Albany, TX 76430-8020
Phone (325) 762-2447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000390 TX Practitioner - Family Practice 8123101805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

301 S Main St
Cross Plains, TX 76443-2581
Phone (254) 725-4311

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
K4521TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shackelford County Community Resource Center CurrentSince Oct 19, 2010 Accepting new patients
Shackelford County Community Resource Center CurrentSince Oct 19, 2010 Accepting new patients
Shackelford County Community Resource Center Past Accepting new patients

Locations

725 Pate St
Albany, TX 76430
Phone (325) 762-2447

2802 W Walker St
Breckenridge, TX 76424
Phone (254) 559-4080

1712 N Access Rd
Clyde, TX 79510
Phone (325) 893-4010

200 N Main St
Cross Plains, TX 76443
Phone (254) 725-7330

301 S Main St
Cross Plains, TX 76443
Phone (254) 725-4311

217 Edwards
Merkel, TX 79536
Phone (325) 928-0014

Interoperability endpoints

  • Direct secure messaging: joanne.paulk.1@28291.direct.athenahealth.com
  • Direct secure messaging: jpaulk@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Resourcecare ClydeClyde, TX, CCN 671976 Federally qualified health center W-2 Managing Employee Oct 1, 2022
Resourcecare MerkelMerkel, TX, CCN 741913 Federally qualified health center Corporate Officer Oct 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1700848850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2435",
            "city": "ALBANY",
            "state": "TX",
            "postal_code": "764308020",
            "telephone_number": "325-762-2447",
            "fax_number": "325-762-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST",
            "city": "CROSS PLAINS",
            "state": "TX",
            "postal_code": "764432581",
            "telephone_number": "254-725-4311",
            "fax_number": "254-725-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "JOANNE",
        "middle_name": "CARPENTER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K4521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Plains, TX

Sources for this page

Verify at the official NPI Registry.