Carebridge Medteam, Llc | |
1600 S Henderson Blvd Kilgore TX 75662-3518 | |
(903) 475-3474 | |
Not Available |
Full Name | Carebridge Medteam, Llc |
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Speciality | Nurse Practitioner |
Location | 1600 S Henderson Blvd, Kilgore, Texas |
Authorized Official Name and Position | Dana Carter (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8329677970 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Carebridge Medteam, Llc 1600 S Henderson Blvd Kilgore TX 75662-3518 Ph: (903) 475-3474 | Carebridge Medteam, Llc 1600 S Henderson Blvd Kilgore TX 75662-3518 Ph: (903) 475-3474 |
NPI Number | 1013741420 |
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Provider Enumeration Date | 08/28/2024 |
Last Update Date | 10/01/2024 |
Medicare PECOS PAC ID | 0547795031 |
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Medicare Enrollment ID | O20241120002889 |
Identifier | Type | State | Issuer |
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1013741420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Diana Lynn Jordan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982055091 PECOS PAC ID: 3375825169 Enrollment ID: I20170201000429 |
Provider Name | Elizabeth A Powell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285134163 PECOS PAC ID: 2062773930 Enrollment ID: I20180312000569 |
Provider Name | Jacquelyn B Hopkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134600919 PECOS PAC ID: 6204180854 Enrollment ID: I20181116001929 |
Provider Name | Tiffany Tyeskie |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437803715 PECOS PAC ID: 4880089184 Enrollment ID: I20220324000041 |
Provider Name | Emily Groce |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629708946 PECOS PAC ID: 6305227687 Enrollment ID: I20220718002574 |
Provider Name | April Luquette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245921659 PECOS PAC ID: 1355786732 Enrollment ID: I20240226000082 |
Provider Name | Holly Kristina Royer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063259992 PECOS PAC ID: 0042750945 Enrollment ID: I20240906000081 |
Michael W. Mcshan, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1711 S Henderson Blvd, Suite 300, Kilgore, TX 75662 Phone: 903-983-1578 | |
Qv Urgent Care Tx Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1016 N Kilgore St, Kilgore, TX 75662 Phone: 903-522-4199 | |
Community Wound Resource, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-475-2713 Fax: 903-942-2930 | |