Panhandle Activity Center LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PANHANDLE ACTIVITY CENTER LLC

Doing business as

Family Care Clinic of Bushland

Practice address

1600 S FM 2381
Bushland, TX 79124-1900

Phone

(806) 310-9855

Fax

(806) 310-9857

NPI assigned

Jan 21, 2022

Last updated

Jan 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Holly L JeffreysNPI 1316958408

Title

Administrator

Phone

(806) 532-2273

Specialties & licenses 1

Addresses

Other names 1

• FAMILY CARE CLINIC OF BUSHLAND Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Holly L Jeffreys, FNP-C

  • Family Nurse Practitioner
  • Panhandle, TX
  • NPI 1316958408
  Authorized official Same address or phone

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1851043756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "PANHANDLE",
            "state": "TX",
            "postal_code": "790680010",
            "telephone_number": "806-310-9855",
            "fax_number": "806-310-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S FM 2381",
            "city": "BUSHLAND",
            "state": "TX",
            "postal_code": "791241900",
            "telephone_number": "806-310-9855",
            "fax_number": "806-310-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANHANDLE ACTIVITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "JEFFREYS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "806-532-2273"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY CARE CLINIC OF BUSHLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adrian Isd
• Bushland Isd
• Stephanie Gayle Donnell, LPC
• Kimberly Ann Garza, MS, CCC-SLP
• Latisha Stovall
• Vega Isd
• Walcott Isd
• Wildorado Isd
• Alysha Corrine Winget

• Family Nurse Practitioner in Bushland, TX
• Providers in Bushland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.