NPIMap

Organization Active NPI

Lone Star Circle of Care

Doing business as Lone Star Circle of Care at Georgetown Women's Center

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
National Provider Identifier
1972866200
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
Doing business as
Lone Star Circle of Care at Georgetown Women's Center
Practice address
1900 Scenic Dr
Suite 3326
Georgetown, TX 78626-7724
Phone
(877) 800-5722
Fax
(512) 869-1788
NPI assigned
Jun 21, 2012
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LONE STAR CIRCLE OF CAREAs reported in NPPES

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 Primary

Addresses

Primary practice location

1900 Scenic Dr
Suite 3326
Georgetown, TX 78626-7724

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3082265-01MedicaidTX

Other names 1

  • Lone Star Circle of Care at Georgetown Women's Center 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…
O20130513000609 TX Part A Provider - Federally Qualified Health Center (FQHC) 5193709392 Practice locations: Georgetown, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972866200. Details of each certification follow.

Federally qualified health center certification: CCN 741808

Legal name
LONE STAR CIRCLE OF CARE
Doing business as
LONE STAR CIRCLE OF CARE AT GEORGETOWN WOMEN'S CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 17, 2012
Last certification
Sep 17, 2012
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 12, 2011 in TX
Enrollment address
1900 Scenic Dr
Ste 3326
Georgetown, TX 78626-7876

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2043460Georgetown Women's Center1900 Scenic Drive Ste 3326, Georgetown, TX 78626Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Georgetown Community Clinic34 organizations share this tax ID, including this one
Part of
Georgetown Community Clinic

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 16

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
Cindy Brien Individual Corporate DirectorBoard Member Jan 1, 2015
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 DirectorBoard Member Jan 1, 2015
Elizabeth Johnson Individual Corporate DirectorBoard Member Jan 1, 2013
Rudolph Metayer Individual Corporate DirectorBoard Member Jan 1, 2017
Kathleen V Butler Individual Corporate OfficerChief Medical Officer Jun 1, 2014
W-2 Managing EmployeeChief Medical Officer Jun 1, 2014
Roland Valle Individual Corporate DirectorBoard Member Jan 27, 2011
Mark Schroeder Individual Corporate DirectorBoard Member 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 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1972866200",
    "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": "1900 SCENIC DR",
            "address_2": "SUITE 3326",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267724",
            "telephone_number": "877-800-5722",
            "fax_number": "512-869-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR CIRCLE OF CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONE STAR CIRCLE OF CARE",
        "enumeration_date": "2012-06-21",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3082265-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Circle of Care at Georgetown Women's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.