Active NPI
Clayton Lee Brackeen, FNP
- Family Nurse Practitioner
- Lubbock, TX
National Provider Identifier
1891332292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP143475
- Practice address
- 4709 66TH St
Lubbock, TX 79414-4877 - Phone
- (806) 701-5844
- Fax
- (806) 701-5845
- NPI assigned
- Dec 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP143475 | TX | Primary |
Addresses
Primary practice location
4709 66TH St
Lubbock, TX 79414-4877
Mailing address
4709 66TH St
Lubbock, TX 79414-4877
Phone (806) 701-5844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4709 66TH St
Lubbock, TX 79414-4877
Phone (806) 701-5844
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.9 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.01
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skin Cancer Institute PLLC | Current | Accepting new patients |
Locations
4709 66th St
Lubbock, TX 79414
Phone (806) 535-7548
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dermatology Physician
- Lubbock, TX
- NPI 1922463959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1891332292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 66TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144877",
"telephone_number": "806-701-5844",
"fax_number": "806-701-5845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4709 66TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144877",
"telephone_number": "806-701-5844",
"fax_number": "806-701-5845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACKEEN",
"first_name": "CLAYTON",
"middle_name": "LEE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-04",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP143475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.