NPIMap

Organization Active NPI

Adventhealth Family Medicine Rural Health Clinics, Inc.

  • Family Medicine Physician
  • Lampasas, TX
National Provider Identifier
1861050569
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS, INC.
Practice address
187 PR 4060
Lampasas, TX 76550
Phone
(512) 556-3621
Fax
(512) 556-4080
NPI assigned
May 29, 2019
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Kimberlee Gabara
Title
Dir Practice Operations
Phone
(512) 556-3621

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

187 PR 4060
Lampasas, TX 76550

Mailing address

PO Box 1819
Lampasas, TX 76550-0015
Phone (512) 556-3621

Other practice location 1

2401 Walker Place Blvd
Copperas Cove, TX 76522-4025
Phone (254) 547-5516

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190919000410 TX Part B Supplier - Clinic/Group Practice 8628308533 Receives reassigned benefits from 15 practitioners
Practice locations: Copperas Cove, TX; Lampasas, TX
O20200306000409 TX Part B Supplier - Independent Clinical Laboratory 8628308533 Practice locations: Lampasas, TX

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Locations

2401 Walker Place Blvd
Copperas Cove, TX 76522
Phone (254) 547-5516

2401 Walker Place Blvd
Ste 200
Copperas Cove, TX 76522
Phone (254) 547-5516

187 Private Road 4060
Ste 200
Lampasas, TX 76550
Phone (512) 556-3621

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1861050569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1819",
            "city": "LAMPASAS",
            "state": "TX",
            "postal_code": "765500015",
            "telephone_number": "512-556-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 PR 4060",
            "city": "LAMPASAS",
            "state": "TX",
            "postal_code": "76550",
            "telephone_number": "512-556-3621",
            "fax_number": "512-556-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Walker Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Copperas Cove",
            "state": "TX",
            "postal_code": "765224025",
            "country_code": "US",
            "telephone_number": "254-547-5516",
            "fax_number": "254-542-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "GABARA",
        "authorized_official_first_name": "KIMBERLEE",
        "authorized_official_title_or_position": "DIR PRACTICE OPERATIONS",
        "authorized_official_telephone_number": "512-556-3621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lampasas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.