NPIMap

Organization Active NPI

Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
National Provider Identifier
1780923045
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LONE STAR CIRCLE OF CARE
Practice address
11111 Research Blvd Ste 295
Austin, TX 78759-5281
Phone
(877) 800-5722
NPI assigned
Feb 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Jonathan David Calvin
Title
Ceo
Phone
(512) 994-1933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X TX Primary

Addresses

Primary practice location

11111 Research Blvd Ste 295
Austin, TX 78759-5281

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other practice location 1

11111 Research Blvd Ste 320
Austin, TX 78759-5732
Phone (877) 800-5722

Other identifiers 1

IdentifierTypeStateIssuer
3123119-02MedicaidTX

Other names 1

  • Lone Star Circle of Care at Northwest Austin Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040622000184 TX Part B Supplier - Clinic/Group Practice 5193709392 Receives reassigned benefits from 181 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Austin, TX; Taylor, TX; Round Rock, TX; Pflugerville, TX; Killeen, TX; Jonestown, TX; Hutto, TX; Harker Heights, TX…
O20130517000108 TX Part A Provider - Federally Qualified Health Center (FQHC) 5193709392 Practice locations: Austin, TX

Federally qualified health center certification: CCN 741816

Legal name
LONE STAR CIRCLE OF CARE
Doing business as
LONE STAR CIRCLE OF CARE AT NORTHWEST AUSTIN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 17, 2013
Last certification
May 17, 2013
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 12, 2011 in TX
Enrollment address
11111 Research Blvd
Ste 295&320
Austin, TX 78759-5264

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 39

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

View all 39

National Provider Directory

National Provider Directory
Tax ID family
Lone Star Circle of Care34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Sasha Bulkley Individual Corporate DirectorBoard Member Dec 1, 2023
Lindsey Tippit Individual Corporate OfficerChief Operations Officer Mar 1, 2019
Nichole J Cook Individual Corporate OfficerCfo Aug 5, 2024
Jo Carcedo Individual Corporate DirectorBoard Member Dec 1, 2024
Jack G Hunnicutt Individual Corporate DirectorBoard Member Feb 1, 2003
Marc Scott Alarcon Individual Corporate DirectorBoard Member Feb 19, 2009
Alton McCallum Individual Corporate DirectorBoard Member Jan 1, 2020
Steve Pena Individual Corporate Director Jan 1, 2015
Elizabeth Johnson Individual Corporate DirectorBoard Member Jan 1, 2013
Rudolph Metayer Individual Corporate Director Jan 1, 2017
Kathleen V Butler Individual Corporate OfficerChief Medical Officer Jun 1, 2014
W-2 Managing EmployeeCmo Jun 1, 2014
Roland Valle Individual Corporate DirectorBoard Member Jan 27, 2011
Mark Schroeder Individual Corporate Director Jan 1, 2017
John Gustainis Individual Corporate DirectorBoard Member Jan 1, 2005
Jonathan D Calvin Individual Corporate OfficerCeo Dec 1, 2020

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1780923045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 RESEARCH BLVD STE 295",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595281",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11111 Research Blvd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787595732",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONE STAR CIRCLE OF CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "CALVIN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-994-1933"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3123119-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Circle of Care at Northwest Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.