NPIMap

Organization Active NPI

Pecan Valley MHMR Region

  • Community/Behavioral Health Agency
  • Granbury, TX
National Provider Identifier
1891915708
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PECAN VALLEY MHMR REGION
Practice address
2101 W Pearl St
Granbury, TX 76048-1894
Phone
(817) 579-4400
NPI assigned
Apr 26, 2007
Last updated
Oct 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Authorized official

Name
Michelle L Leonard
Title
Billing Manager
Phone
(817) 579-4400

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU
Psychiatry Physician 2084P0800X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2101 W Pearl St
Granbury, TX 76048-1894

Mailing address

2101 W Pearl St
Granbury, TX 76048-1894
Phone (817) 579-4400

Other practice location 1

1715 Santa Fe Dr
Weatherford, TX 76086-6419
Phone (817) 599-7634

Other practice location 2

1601 N Anglin St
Cleburne, TX 76031-1835
Phone (817) 558-1121

Other practice location 3

906 W Lingleville Rd
Stephenville, TX 76401-2118
Phone (254) 968-4181

Other practice location 4

104 Pirate Dr
Granbury, TX 76048-5682
Phone (817) 573-2662

Other practice location 5

650 W Green St
Stephenville, TX 76401-3311
Phone (254) 965-7806

Other practice location 6

1715 Santa Fe Dr
Weatherford, TX 76086-6419
Phone (817) 579-4400

Other practice location 7

100 Travis Drive
Mineral Wells, TX 76068
Phone (940) 325-9541

Other identifiers 1

IdentifierTypeStateIssuer
130724106MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000171 TX Part B Supplier - Clinic/Group Practice 4688627706 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: Weatherford, TX; Geln Rose, TX; Stephenville, TX; Mineral Wells, TX; Granbury, TX; Cleburne, TX

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Pecan Valley MHMR Region23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

2101 W Pearl St
Granbury, TX 76048
Phone (817) 552-2007

906 W Lingleville Rd
Stephenville, TX 76401
Phone (254) 968-4181

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1891915708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481894",
            "telephone_number": "817-579-4400",
            "fax_number": "866-452-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481894",
            "telephone_number": "817-579-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760866419",
            "country_code": "US",
            "telephone_number": "817-599-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 N Anglin St",
            "address_purpose": "LOCATION",
            "city": "Cleburne",
            "state": "TX",
            "postal_code": "760311835",
            "country_code": "US",
            "telephone_number": "817-558-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "906 W Lingleville Rd",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764012118",
            "country_code": "US",
            "telephone_number": "254-968-4181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Pirate Dr",
            "address_purpose": "LOCATION",
            "city": "Granbury",
            "state": "TX",
            "postal_code": "760485682",
            "country_code": "US",
            "telephone_number": "817-573-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 W Green St",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764013311",
            "country_code": "US",
            "telephone_number": "254-965-7806",
            "fax_number": "254-965-4308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1715 Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760866419",
            "country_code": "US",
            "telephone_number": "817-579-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Travis Drive",
            "address_purpose": "LOCATION",
            "city": "Mineral Wells",
            "state": "TX",
            "postal_code": "76068",
            "country_code": "US",
            "telephone_number": "940-325-9541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PECAN VALLEY MHMR REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "817-579-4400"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130724106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.