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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHACKELFORD COUNTY HEALTH CLINIC
NPI 1184942799
Family Medicine in Albany, TX

Active since May 06, 2010CLIA 45D2010421 · Waiver
450 KENSHALO ST, ALBANY, TX 76430(325) 762-3661(325) 762-3859 Get Directions Write a Review

NPPES record last updated: October 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 8, 2026, Jul 27, 2026, Dec 9, 2020 and 1 more (4 updates tracked since 2019).

About Shackelford County Health Clinic NPPES

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

SHACKELFORD COUNTY HEALTH CLINIC (NPI 1184942799) is a healthcare organization registered as a family medicine in Albany, Texas and active in the NPI registry since May 2010. The organization holds a CLIA Waiver certificate valid through July 26, 2028 and lists Brandi Green, District Administrator, as its authorized official.

NPPES Registry Identity

NPI1184942799
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSHACKELFORD COUNTY HEALTH CLINIC
Location Address450 KENSHALO STAlbany, TX 76430-3218
Mailing AddressPo Box 2470Albany, TX 76430 · (325) 762-3661 · Fax (325) 762-3859
Phone(325) 762-3661
Fax(325) 762-3859
Organization SubpartNo
Authorized OfficialBrandi GreenDistrict Administrator · (325) 762-3661
Enumeration DateMay 6, 2010
Last NPPES UpdateOctober 8, 20264 updates tracked since enumeration
NPPES CertifiedOctober 8, 2026
✔ NPI 1184942799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
450 KENSHALO ST, Albany, TX 76430
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Other Identifiers 3

Other10135791TX · United Healthcare
Medicaid220311901TX
Other0071TQTX · Bcbs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shackelford County Health Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Shackelford County Health Clinic, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Ray Gibson, DO
Family Practice
NPI 1750324836
450 KENSHALO ST
Albany, TX 76430
(325) 762-3661
✔ PECOS✔ Accepts MedicareSame address
Claire Ware, FNP-C
Nurse Practitioner
NPI 1912453481
450 KENSHALO ST
Albany, TX 76430
(325) 762-3661
✔ PECOS✔ Accepts MedicareSame address
Travis Wilburn, FNP-C
Nurse Practitioner
NPI 1770513194
450 KENSHALO
Albany, TX 76430
(325) 762-3661
✔ PECOS✔ Accepts MedicareSame address

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

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 45D2010421

Shackelford County Health Clinic Corg · Albany, TX
Active · expires Jul 26, 2028
CLIA Number45D2010421
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2026
Certificate Expiration DateJuly 26, 2028
Laboratory DirectorNeil Gibson
Laboratory Phone(325) 762-3661
Laboratory LocationShackelford County Health Clinic Corg450 Kenshalo, Albany, TX 76430
CLIA data matches this NPI record on: Address Name Phone
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 Shackelford County Health Clinic's NPI number?

The NPI number for Shackelford County Health Clinic is 1184942799. It was assigned to this organization in the NPPES registry on May 6, 2010.

Where is Shackelford County Health Clinic located?

Shackelford County Health Clinic is located at 450 Kenshalo St, Albany, TX 76430. The listed phone number is (325) 762-3661.

What is Shackelford County Health Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shackelford County Health Clinic enrolled in Medicare?

Yes. Shackelford County Health Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shackelford County Health Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Shackelford County Health Clinic, in Family Practice and Nurse Practitioner. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Shackelford County Health Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2010421) is associated with this NPI, valid through July 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Shackelford County Health Clinic was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.