| Cedar Crest Clinic | |
|
3500 S Ih 35 Belton TX 76513-9426 | |
| (254) 519-4162 | |
| (254) 519-3464 |
| Full Name | Cedar Crest Clinic |
|---|---|
| Speciality | Counselor |
| Location | 3500 S Ih 35, Belton, Texas |
| Authorized Official Name and Position | Brian P Farley (VP & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Crest Clinic 6100 Tower Cir Ste 1000 Franklin TN 37067-1509 Ph: (615) 861-6000 | Cedar Crest Clinic 3500 S Ih 35 Belton TX 76513-9426 Ph: (254) 519-4162 |
| NPI Number | 1710936380 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 9537063409 |
|---|---|
| Medicare Enrollment ID | O20031121000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710936380 | NPI | - | NPPES |
| 148187101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sejal S Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982612040 PECOS PAC ID: 4981662723 Enrollment ID: I20041228000218 |
| Provider Name | Taghi Shafie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568478352 PECOS PAC ID: 6406804756 Enrollment ID: I20050104000536 |
| Provider Name | Kimberly A Cotton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194757385 PECOS PAC ID: 5193768588 Enrollment ID: I20050607000381 |
| Provider Name | Vanajakshi Paturu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598876369 PECOS PAC ID: 6406957802 Enrollment ID: I20090601000032 |
| Provider Name | Karley Y Little |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467553198 PECOS PAC ID: 4082612023 Enrollment ID: I20121017000629 |
| Provider Name | Shree Shrestha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760594329 PECOS PAC ID: 4587798491 Enrollment ID: I20130815000676 |
| Provider Name | Muminot O Ogunmuyiwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225469976 PECOS PAC ID: 7719116771 Enrollment ID: I20140215000027 |
| Provider Name | John E Pierson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447664313 PECOS PAC ID: 1254619786 Enrollment ID: I20161103000434 |
| Provider Name | Reginald Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801348321 PECOS PAC ID: 7810269578 Enrollment ID: I20170816001392 |
| Provider Name | Casey Coton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114461530 PECOS PAC ID: 3779864350 Enrollment ID: I20170818002223 |
| Provider Name | Marc Biala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336661974 PECOS PAC ID: 0547533358 Enrollment ID: I20170830000560 |
| Provider Name | Caleb Jordan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619361904 PECOS PAC ID: 2567771249 Enrollment ID: I20171106002287 |
| Provider Name | Pauravi Rana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801010194 PECOS PAC ID: 7113279225 Enrollment ID: I20181017002040 |
| Provider Name | Christina S Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396159679 PECOS PAC ID: 0648523282 Enrollment ID: I20181029000500 |
| Provider Name | Zachary Robert Drennan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841728011 PECOS PAC ID: 8325317076 Enrollment ID: I20190123000520 |
| Provider Name | Babatunde F Fagbamiye |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467551531 PECOS PAC ID: 7012904576 Enrollment ID: I20190314002253 |
| Provider Name | Sandra S Vexler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285994384 PECOS PAC ID: 3072864339 Enrollment ID: I20190401000265 |
| Provider Name | Susan J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639739980 PECOS PAC ID: 1456688803 Enrollment ID: I20190808001702 |
| Provider Name | Princess D Eghianruwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477161164 PECOS PAC ID: 1052736691 Enrollment ID: I20200730000872 |
| Provider Name | Julie Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619196714 PECOS PAC ID: 1355755083 Enrollment ID: I20210330000265 |
| Provider Name | Bryan Ross Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497325690 PECOS PAC ID: 6709282700 Enrollment ID: I20210830003188 |
| Provider Name | Jayanth Bolaram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336251016 PECOS PAC ID: 1254325095 Enrollment ID: I20210915002567 |
| Provider Name | Jesika Vershawn Sweet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245808484 PECOS PAC ID: 3274922760 Enrollment ID: I20211123001861 |
| Provider Name | Krystel Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235895491 PECOS PAC ID: 7214328038 Enrollment ID: I20220104002984 |
| Provider Name | Kimberly Irene Vance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013660802 PECOS PAC ID: 6103206180 Enrollment ID: I20220708000016 |
| Provider Name | Teresiah S Musyoka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497329445 PECOS PAC ID: 8527437375 Enrollment ID: I20221216002529 |
| Provider Name | Katherine Blakemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023727591 PECOS PAC ID: 9133590573 Enrollment ID: I20230124000418 |
| Provider Name | Janet Oladipo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053073114 PECOS PAC ID: 9032505177 Enrollment ID: I20230201002920 |
| Provider Name | Drew Edward Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164983235 PECOS PAC ID: 7517294788 Enrollment ID: I20231030000387 |
| Provider Name | Nasim Akther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881903623 PECOS PAC ID: 1850730151 Enrollment ID: I20240419000813 |
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