GENESIS PRIMECARE
NPI 1093186249
Clinic/Center - Federally Qualified Health Center (FQHC) in Texarkana, AR

Active since October 14, 2015CLIA Certified · 3 labs
1205 E 35TH ST, TEXARKANA, AR 71854(870) 216-0080(870) 216-0093 Get Directions Write a Review

NPPES record last updated: December 12, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 12, 2024, Jun 13, 2024, Aug 28, 2023 and 5 more (8 updates tracked since 2018).

About Genesis Primecare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS PRIMECARE (NPI 1093186249) is a healthcare organization registered as a federally qualified health center (fqhc) in Texarkana, Arkansas and active in the NPI registry since October 2015. The organization holds 3 active CLIA laboratory certificates and lists Carla Roadcap, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093186249
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameEAST TEXAS BORDER HEALTH CLINIC
Location Address1205 E 35TH STTexarkana, AR 71854-2746
Mailing AddressPo Box 1326Marshall, TX 75671-1326 · (903) 927-3782 · Fax (903) 927-1764
Fax(870) 216-0093
Organization SubpartNo
Authorized OfficialCarla RoadcapCeo · (903) 927-3782
Enumeration DateOctober 14, 2015
Last NPPES UpdateDecember 12, 20248 updates tracked since enumeration
NPPES CertifiedDecember 12, 2024
✔ NPI 1093186249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPediatricsTaxonomy 208000000X
1205 E 35TH ST, Texarkana, AR 71854

Other Names 1

Doing Business AsGenesis Primecare

Other Identifiers 2

Medicaid213389749AR
Medicaid356940201TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Genesis Primecare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

21

Medicare enrollment records show 21 clinicians reassign Medicare billing to Genesis Primecare, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 20 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Nurse Practitioner10
Mental Health Counselor6
Clinical Social Worker3
Family Practice1
Obstetrics/Gynecology1

Nearest to this location (20)

See all 21
Nurse Practitioner
NPI 1508236027
1205 E 35TH ST
Texarkana, AR 71854
(870) 216-0080
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1104316819
1205 E 35TH ST
Texarkana, AR 71854
(870) 216-0050
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1770605057
1205 E 35TH ST
Texarkana, AR 71854
(870) 216-0080
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1275918625
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1932262995
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Mental Health Counselor
NPI 1275769903
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Mental Health Counselor
NPI 1740826874
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Mental Health Counselor
NPI 1407977648
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Mental Health Counselor
NPI 1417578154
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Clinical Social Worker
NPI 1962154567
4077 JEFFERSON AVE
Texarkana, AR 71854
(870) 330-9200
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1992081491
2118 N STATE LINE AVE
Texarkana, AR 71854
(870) 703-7764
✔ PECOS✔ Accepts Medicare1.2 mi
Nurse Practitioner
NPI 1598286734
1400 COLLEGE DR STE 204
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Nurse Practitioner
NPI 1144191305
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Nurse Practitioner
NPI 1720416308
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Clinical Social Worker
NPI 1578066452
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Nurse Practitioner
NPI 1154158699
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Clinical Social Worker
NPI 1073892634
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Family Practice
NPI 1558368498
1400 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Obstetrics/Gynecology
NPI 1750381158
1408 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS✔ Accepts Medicare1.9 mi
Nurse Practitioner
NPI 1124396833
1411 COLLEGE DR
Texarkana, TX 75503
(903) 791-1110
✔ PECOS1.9 mi
See all 21 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2105446

Genesis Primecare East Texas Border Health · Texarkana, AR
Active · expires Nov 23, 2027
CLIA Number04D2105446
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateNovember 24, 2025
Certificate Expiration DateNovember 23, 2027
Laboratory DirectorDr. Jeffory Beaty
Laboratory Phone(870) 216-0080
Laboratory LocationGenesis Primecare East Texas Border Health1205 East 35th Street, Texarkana, AR 71854
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2132160

Genesis Primecare-Marshall Pediatrics · Marshall, TX
Active · expires Jun 12, 2027
CLIA Number45D2132160
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 13, 2025
Certificate Expiration DateJune 12, 2027
Laboratory DirectorJeffory Beaty
Laboratory Phone(903) 927-3782
Laboratory LocationGenesis Primecare-Marshall Pediatrics1900 North East End Blvd, Marshall, TX 75670
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 04D2161047

Genesis Primecare East Texas Border Health Clinic · Texarkana, AR
Active · expires Jan 23, 2027
CLIA Number04D2161047
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorDr. Jeffory Beaty
Laboratory Phone(870) 330-9200
Laboratory LocationGenesis Primecare East Texas Border Health Clinic4077 Jefferson Ave, Texarkana, AR 71854
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Texas Border Health Clinic's NPI number?

The NPI number for East Texas Border Health Clinic is 1093186249. It was assigned to this organization in the NPPES registry on October 14, 2015. The provider is doing business as Genesis Primecare.

Where is East Texas Border Health Clinic located?

East Texas Border Health Clinic is located at 1205 E 35th St, Texarkana, AR 71854. The listed phone number is (870) 216-0080.

What is East Texas Border Health Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is East Texas Border Health Clinic enrolled in Medicare?

Yes. East Texas Border Health Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Texas Border Health Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 5 Medicare specialties reassign their Medicare billing to East Texas Border Health Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (10), Mental Health Counselor (6) and Clinical Social Worker (3). Of these, 3 practice at this address and 20 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does East Texas Border Health Clinic hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does East Texas Border Health Clinic accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 3 other insurers list East Texas Border Health Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for East Texas Border Health Clinic was last updated on December 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.