Organization Active NPI

Jr Family Healthcare, PLLC

Doing business as Houston County Family Medical Clinic

  • Rural Health Clinic/Center
  • Crockett, TX
National Provider Identifier
1750921441
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JR FAMILY HEALTHCARE, PLLC
Doing business as
Houston County Family Medical Clinic
Practice address
1501 E Loop 304 Ste 50
Crockett, TX 75835-3417
Phone
(832) 964-6436
NPI assigned
Jan 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Dr. Natalie Elizabeth Bachynsky, PHD, FNP-C, APRNNPI 1366840068
Title
Member/Family Nurse Practitioner
Phone
(832) 964-6436

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1501 E Loop 304 Ste 50
Crockett, TX 75835-3417

Mailing address

6505 FM 1280 E
Lovelady, TX 75851-3688
Phone (936) 544-7223

Other identifiers 1

IdentifierTypeStateIssuer
408787601MedicaidTX

Other names 1

  • Houston County Family Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200221000578 TX Part B Supplier - Clinic/Group Practice 2466889027 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Chester, TX; Crockett, TX
O20200430001826 TX Part A Provider - Rural Health Clinic 2466889027 Practice locations: Crockett, TX

Rural health clinic certification: CCN 673953

Legal name
JR FAMILY HEALTHCARE, PLLC
Doing business as
HOUSTON COUNTY FAMILY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 9, 2020
Last certification
Mar 31, 2026
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Dec 3, 2019 in TX
Enrollment address
1501 E Loop 304
Ste 50
Crockett, TX 75835-3419

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
45D2178041Houston County Family Medical Clinic1501 East Loop 304, Ste 50, Crockett, TX 75835Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Jr Family Healthcare PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1501 E Loop 304
Ste 50
Crockett, TX 75835
Phone (936) 544-7223

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ashton Bachynsky Individual Corporate OfficerClinic Administrator Dec 3, 2019
W-2 Managing EmployeeClinic Administrator Dec 3, 2019
Natalie Ea Bachynsky Individual 5% Or Greater Direct Ownership Interest Dec 3, 2019 100%
Corporate OfficerCeo Dec 3, 2019 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1750921441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 FM 1280 E",
            "city": "LOVELADY",
            "state": "TX",
            "postal_code": "758513688",
            "telephone_number": "936-544-7223",
            "fax_number": "936-544-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E LOOP 304 STE 50",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758353417",
            "telephone_number": "832-964-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR FAMILY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "BACHYNSKY",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MEMBER/FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "832-964-6436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, FNP-C, APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408787601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houston County Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Houston County Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crockett, TX

Sources for this page

Verify at the official NPI Registry.