KERI JO WELLBORN (NPI# 1972915775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972915775 |
| Entity Type | Individual |
| Full Name | KERI JO WELLBORN |
| Credential | MD |
| Practice Address |
1001 Us Highway 83 N Childress TX 79201-2322 |
| Mailing Address |
Po Box 1030 Childress TX 79201-1030 |
| Practice Telephone | 9409373636 |
| Practice Fax Number | 9409379615 |
| Mailing Telephone | 9409373636 |
| Mailing Fax Number | 9409379615 |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2020-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Q7030 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 355764703 | 05 | |
| DEA | FC5976836 | 01 | |
| TX | TEXAS MEDICAL BOARD | Q7030 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Providence Dr, Waco, TX 767072261 | 2543134200 | 2543134326 |
| Street Address |
1001 US HIGHWAY 83 N |
| City | CHILDRESS |
| State | TX |
| Zip Code | 79201-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629022520 | Amarillo Vamc | Clinic/Center | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2006-05-22 |
| 1043845795 | Carley Brandon | Nurse Practitioner | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2020-03-03 |
| 1962945451 | Lauren Ashley Bratton | Nurse Practitioner | 1001 Us Highway 83 N, Childress, TX 79201 | 2016-12-01 |
| 1952771446 | Jessica Boedeker | Nurse Practitioner | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2015-09-28 |
| 1952799249 | David Bratton | Social Worker | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2015-01-08 |
| 1053721910 | Kimberly Hagar | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2014-04-30 |
| 1649533969 | David Craig Schaefer | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2012-06-21 |
| 1124384342 | Meagan Orene Jarboe Husband | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2012-04-02 |
| 1780971119 | Deane Nicole Crim | Physician Assistant | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2011-07-06 |
| 1386962892 | Nicholas Souder, Md, P.a. | Orthopaedic Surgery | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2010-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013567684 | Amie Hope Thomas | Counselor | 132 N Main St Ste D, Childress, TX 79201 | 2019-09-16 |
| 1710465182 | Tara Sims | Counselor | 101 Avenue C Ne, Childress, TX 79201 | 2018-07-30 |
| 1013391242 | Amanda Jo Browning Tucker | Optometrist | 707 Avenue F Nw, Childress, TX 79201 | 2015-07-17 |
| 1811332257 | Childress Outpost Pharmacy Inc | Pharmacy | 805 Hwy 83 N., Childress, TX 79201 | 2013-04-29 |
| 1700196748 | Cheryl Lynn Gary | Nurse Practitioner | 901 Hwy 83, Childress, TX 79201 | 2010-10-08 |
| 1205093341 | Dr Lendon Davis | Optometrist | 500 2nd St Ne, Childress, TX 79201 | 2008-05-16 |
| 1871777805 | Aimee Bowman | Physical Therapist | 901 Hwy 83 North, Childress, TX 79201 | 2007-12-27 |
| 1386726628 | Joseph Steele | Anesthesiology | 901 Highway 83 North, Childress, TX 79201 | 2006-10-19 |
| 1235220880 | Peter N Jones | Nurse Practitioner | 1001 Us Hwy 83 N, Childress, TX 79201 | 2006-09-27 |
| 1174625362 | Childress County Hospital District | Clinic/Center | 910 Rear Oak Lane, Childress, TX 79201 | 2006-09-01 |
| Find all providers in zip 79201 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912199456 | Dustin Robert Pratt | Family Medicine | 1001 Highway 83 North, Childress, TX 79201-1030 | 2007-08-17 |
| 1053721910 | Kimberly Hagar | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2014-04-30 |
| 1649533969 | David Craig Schaefer | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2012-06-21 |
| 1124384342 | Meagan Orene Jarboe Husband | Family Medicine | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2012-04-02 |
| 1558462465 | Richard David Caldwell | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| 1467553370 | Thomas Craig Darter | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| 1376644286 | James M Henderson | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| 1609977511 | Weldon D Green | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| 1174624084 | Honorato P Olay Jr. | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| 1588765499 | Dondi D Ridens | Family Medicine | 1001 Hwy 83 N, Childress, TX 79201 | 2006-09-25 |
| Find all providers in CHILDRESS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.